| Hafermann Counseling Collaborative, Llc | |
|
320 W Grand Ave Ste 204 Wisconsin Rapids WI 54495-2781 | |
| (715) 421-1107 | |
| (715) 421-1108 |
| Full Name | Hafermann Counseling Collaborative, Llc |
|---|---|
| Speciality | Counselor |
| Location | 320 W Grand Ave Ste 204, Wisconsin Rapids, Wisconsin |
| Authorized Official Name and Position | Janelle Hafermann (OWNER) |
| Authorized Official Contact | 7153421110 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hafermann Counseling Collaborative, Llc 320 W Grand Ave Ste 204 Wisconsin Rapids WI 54495-2781 Ph: (715) 421-1107 | Hafermann Counseling Collaborative, Llc 320 W Grand Ave Ste 204 Wisconsin Rapids WI 54495-2781 Ph: (715) 421-1107 |
| NPI Number | 1558043711 |
|---|---|
| Provider Enumeration Date | 08/07/2023 |
| Last Update Date | 12/13/2023 |
| Certification Date | 12/13/2023 |
| Medicare PECOS PAC ID | 2860845310 |
|---|---|
| Medicare Enrollment ID | O20240131002952 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558043711 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Janelle Kathleen Hafermann |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1174952352 PECOS PAC ID: 6305299850 Enrollment ID: I20240131003063 |
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