| Innervisions Counseling & Consulting Center, S.c. | |
|
840 State Road 136 Ste 1 Baraboo WI 53913-9252 | |
| (608) 477-9858 | |
| (877) 560-0578 |
| Full Name | Innervisions Counseling & Consulting Center, S.c. |
|---|---|
| Speciality | Clinic/Center |
| Location | 840 State Road 136 Ste 1, Baraboo, Wisconsin |
| Authorized Official Name and Position | Colleen Suzanna James (DIRECTOR) |
| Authorized Official Contact | 6084779858 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Innervisions Counseling & Consulting Center, S.c. 840 State Road 136 Ste 1 Baraboo WI 53913-9252 Ph: (608) 477-9858 | Innervisions Counseling & Consulting Center, S.c. 840 State Road 136 Ste 1 Baraboo WI 53913-9252 Ph: (608) 477-9858 |
| NPI Number | 1639402902 |
|---|---|
| Provider Enumeration Date | 09/17/2009 |
| Last Update Date | 01/09/2023 |
| Certification Date | 01/09/2023 |
| Medicare PECOS PAC ID | 8527297498 |
|---|---|
| Medicare Enrollment ID | O20140219000852 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639402902 | NPI | - | NPPES |
| 39602100 | Medicaid | WI |
| Provider Name | Colleen S James |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598829897 PECOS PAC ID: 4688803562 Enrollment ID: I20140219001004 |
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