| Wisconsin Lutheran Child & Family Service | |
|
5300 N Meade St Appleton WI 54913-8383 | |
| (800) 438-1772 | |
| (262) 293-9737 |
| Full Name | Wisconsin Lutheran Child & Family Service |
|---|---|
| Speciality | Counselor - Professional |
| Location | 5300 N Meade St, Appleton, Wisconsin |
| Authorized Official Name and Position | Mark Klug (CEO) |
| Authorized Official Contact | 8886859522 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wisconsin Lutheran Child & Family Service W175n11120 Stonewood Dr Attn Linda R Germantown WI 53022-6511 Ph: (800) 438-1772 | Wisconsin Lutheran Child & Family Service 5300 N Meade St Appleton WI 54913-8383 Ph: (800) 438-1772 |
| NPI Number | 1043661036 |
|---|---|
| Provider Enumeration Date | 06/30/2016 |
| Last Update Date | 02/04/2022 |
| Certification Date | 02/04/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043661036 | NPI | - | NPPES |
| 42171800 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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