| Life Point Counseling, Llc | |
|
2209 Eastern Ave Plymouth WI 53073-4281 | |
| (920) 892-7606 | |
| (920) 449-4247 |
| Full Name | Life Point Counseling, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2209 Eastern Ave, Plymouth, Wisconsin |
| Authorized Official Name and Position | Molly Ellen Steuerwald (OFFICE MANAGER) |
| Authorized Official Contact | 9208927606 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Life Point Counseling, Llc 2209 Eastern Ave Plymouth WI 53073-4281 Ph: (920) 892-7606 | Life Point Counseling, Llc 2209 Eastern Ave Plymouth WI 53073-4281 Ph: (920) 892-7606 |
| NPI Number | 1407097371 |
|---|---|
| Provider Enumeration Date | 03/23/2009 |
| Last Update Date | 04/27/2023 |
| Certification Date | 04/27/2023 |
| Medicare PECOS PAC ID | 1254740525 |
|---|---|
| Medicare Enrollment ID | O20210518000621 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407097371 | NPI | - | NPPES |
| 100061500 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 3459-125 (Wisconsin) | Primary |
| Provider Name | Craig L Abrams |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1750367116 PECOS PAC ID: 5496784225 Enrollment ID: I20050811000444 |
| Provider Name | Tanya L Bricco |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669816278 PECOS PAC ID: 4880917525 Enrollment ID: I20150102001573 |
| Provider Name | Angela Wessels |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1255885539 PECOS PAC ID: 2860843380 Enrollment ID: I20240109004309 |
| Provider Name | Troy E Krepsky |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1720331119 PECOS PAC ID: 6709238512 Enrollment ID: I20240117003028 |
| Provider Name | Jennifer Ann Kalista |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1467163550 PECOS PAC ID: 6507305273 Enrollment ID: I20240826002489 |
| Provider Name | Kirstin Opgenorth |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386373835 PECOS PAC ID: 3274067780 Enrollment ID: I20241106002335 |
| Provider Name | Tina Marie Ottman-boykin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760595300 PECOS PAC ID: 8921040122 Enrollment ID: I20250318001419 |
Northern Wisconsin Geriatric Psychological Services, Sc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 859 Chaplin Ct, Plymouth, WI 53073 Phone: 920-893-8000 |