| Kim Lagro Counseling Services,llc | |
|
2207 E 5th St Superior WI 54880-3780 | |
| (715) 256-8907 | |
| (715) 256-8906 |
| Full Name | Kim Lagro Counseling Services,llc |
|---|---|
| Speciality | Social Worker |
| Location | 2207 E 5th St, Superior, Wisconsin |
| Authorized Official Name and Position | Kim Louise Lagro (OWNER) |
| Authorized Official Contact | 7152568907 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kim Lagro Counseling Services,llc 4099 E Leggate Rd Superior WI 54880-8347 Ph: (715) 817-0209 | Kim Lagro Counseling Services,llc 2207 E 5th St Superior WI 54880-3780 Ph: (715) 256-8907 |
| NPI Number | 1023684552 |
|---|---|
| Provider Enumeration Date | 06/03/2021 |
| Last Update Date | 02/06/2022 |
| Certification Date | 02/06/2022 |
| Medicare PECOS PAC ID | 9739572637 |
|---|---|
| Medicare Enrollment ID | O20220216001566 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023684552 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Kim L Lagro |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790289056 PECOS PAC ID: 3678837036 Enrollment ID: I20220216001664 |
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