| Balanced Solution Therapies | |
|
621 W Lawrence St # 105 Appleton WI 54911-5834 | |
| (920) 277-9085 | |
| Not Available |
| Full Name | Balanced Solution Therapies |
|---|---|
| Speciality | Counselor |
| Location | 621 W Lawrence St # 105, Appleton, Wisconsin |
| Authorized Official Name and Position | Kristal K Wichman (OWNER) |
| Authorized Official Contact | 9202779085 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Balanced Solution Therapies 621 W Lawrence St # 105 Appleton WI 54911-5834 Ph: (920) 277-9085 | Balanced Solution Therapies 621 W Lawrence St # 105 Appleton WI 54911-5834 Ph: (920) 277-9085 |
| NPI Number | 1942875323 |
|---|---|
| Provider Enumeration Date | 05/26/2021 |
| Last Update Date | 05/02/2023 |
| Certification Date | 05/02/2023 |
| Medicare PECOS PAC ID | 5496157596 |
|---|---|
| Medicare Enrollment ID | O20210713000136 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942875323 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Kristal K Wichman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902002371 PECOS PAC ID: 5799088910 Enrollment ID: I20160122000082 |
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