| Northside Mental Health And Consulting Llc | |
|
1310 Mendota St Suite 114 Madison WI 53714-1039 | |
| (608) 577-4555 | |
| Not Available |
| Full Name | Northside Mental Health And Consulting Llc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 1310 Mendota St, Madison, Wisconsin |
| Authorized Official Name and Position | Christopher Jay Wirth (OWNER/PSYCHOTHERAPIST) |
| Authorized Official Contact | 6085774555 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northside Mental Health And Consulting Llc 1310 Mendota St Suite 114 Madison WI 53714-1039 Ph: (608) 577-4555 | Northside Mental Health And Consulting Llc 1310 Mendota St Suite 114 Madison WI 53714-1039 Ph: (608) 577-4555 |
| NPI Number | 1841584695 |
|---|---|
| Provider Enumeration Date | 06/08/2011 |
| Last Update Date | 06/08/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841584695 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | 183-228 (Wisconsin) | Primary |
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