| Life Space Counseling Llc | |
|
215 N Main St Suite 201 West Bend WI 53095-3347 | |
| (920) 960-7232 | |
| (920) 923-2736 |
| Full Name | Life Space Counseling Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 215 N Main St, West Bend, Wisconsin |
| Authorized Official Name and Position | Linda Kirk (OWNER) |
| Authorized Official Contact | 9209607232 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Life Space Counseling Llc N5389 Buena Vista Dr Fond Du Lac WI 54937-7372 Ph: (920) 960-7232 | Life Space Counseling Llc 215 N Main St Suite 201 West Bend WI 53095-3347 Ph: (920) 960-7232 |
| NPI Number | 1174067821 |
|---|---|
| Provider Enumeration Date | 12/15/2016 |
| Last Update Date | 12/15/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174067821 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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