| Exodus Counseling Center, Inc. | |
|
5800 North Bayshore Drive Suite B 204 Glendale WI 53217 | |
| (414) 964-4357 | |
| (414) 964-4327 |
| Full Name | Exodus Counseling Center, Inc. |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 5800 North Bayshore Drive, Glendale, Wisconsin |
| Authorized Official Name and Position | Scott Stoner (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 4149644357 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Exodus Counseling Center, Inc. 5800 North Bayshore Dr Suite B 204 Glendale WI 53217 Ph: (414) 964-4357 | Exodus Counseling Center, Inc. 5800 North Bayshore Drive Suite B 204 Glendale WI 53217 Ph: (414) 964-4357 |
| NPI Number | 1871713628 |
|---|---|
| Provider Enumeration Date | 04/26/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871713628 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | STATE MANDATED (Wisconsin) | Primary |
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