| Ichthus Counseling, Llc | |
|
11124 N Cedarburg Rd Suite 310 Mequon WI 53092-4361 | |
| (262) 478-0032 | |
| (262) 478-0082 |
| Full Name | Ichthus Counseling, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 11124 N Cedarburg Rd, Mequon, Wisconsin |
| Authorized Official Name and Position | John R Briggs (LICENSED PSYCHOLOGIST) |
| Authorized Official Contact | 2624780032 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ichthus Counseling, Llc 11124 N Cedarburg Rd Suite 310 Mequon WI 53092-4361 Ph: (262) 478-0032 | Ichthus Counseling, Llc 11124 N Cedarburg Rd Suite 310 Mequon WI 53092-4361 Ph: (262) 478-0032 |
| NPI Number | 1922126721 |
|---|---|
| Provider Enumeration Date | 03/27/2007 |
| Last Update Date | 03/03/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922126721 | NPI | - | NPPES |
| 39128000 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 2591 (Wisconsin) | Primary |
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