| Counseling & Development Center | |
|
171 Chestnut St Phillips WI 54555-1313 | |
| (715) 339-3048 | |
| (715) 339-2436 |
| Full Name | Counseling & Development Center |
|---|---|
| Speciality | Counselor |
| Location | 171 Chestnut St, Phillips, Wisconsin |
| Authorized Official Name and Position | Julie Seidl (FINANCIAL MANAGER) |
| Authorized Official Contact | 7153393048 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Counseling & Development Center 171 Chestnut St Po Box 71 Phillips WI 54555-1313 Ph: (715) 339-3048 | Counseling & Development Center 171 Chestnut St Phillips WI 54555-1313 Ph: (715) 339-3048 |
| NPI Number | 1760524854 |
|---|---|
| Provider Enumeration Date | 02/13/2007 |
| Last Update Date | 12/11/2009 |
| Medicare PECOS PAC ID | 6800826488 |
|---|---|
| Medicare Enrollment ID | O20050813000111 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760524854 | NPI | - | NPPES |
| 42141300 | Medicaid | WI | |
| 3931356642010 | Other | WI | BLUE CROSS BLUE SHIEL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 1244 (Wisconsin) | Primary |
| Provider Name | Koti R Mannem |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1720188717 PECOS PAC ID: 7911964200 Enrollment ID: I20041218000041 |
| Provider Name | Randall K Cullen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1255368346 PECOS PAC ID: 4486689015 Enrollment ID: I20051003000031 |
Safe Haven Counseling Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 548 N Lake Ave, Phillips, WI 54555 Phone: 715-339-6453 Fax: 715-339-6450 | |
Price County Human Services Dept Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 104 S Eyder Ave, Phillips, WI 54555 Phone: 715-339-2158 Fax: 715-339-4018 | |
Counseling & Development Center, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 171 Chestnut Street, Phillips, WI 54555 Phone: 715-339-3048 | |
County Of Price Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 104 S Eyder Ave, Phillips, WI 54555 Phone: 715-339-2158 | |
Price County Human Services Dept Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 104 S Eyder Ave, Phillips, WI 54555 Phone: 715-339-2158 Fax: 715-339-4018 | |
Serene Counseling, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 148 S Avon Ave, Phillips, WI 54555 Phone: 715-661-4474 |