| Living Well Mental Health Clinic Llc | |
|
112 N Central Ave Owen WI 54460 | |
| (715) 313-4748 | |
| (715) 229-0331 |
| Full Name | Living Well Mental Health Clinic Llc |
|---|---|
| Speciality | Psychologist |
| Location | 112 N Central Ave, Owen, Wisconsin |
| Authorized Official Name and Position | Becca Greub (CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 7153134748 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Living Well Mental Health Clinic Llc Po Box 65 Owen WI 54460-0065 Ph: (715) 229-0330 | Living Well Mental Health Clinic Llc 112 N Central Ave Owen WI 54460 Ph: (715) 313-4748 |
| NPI Number | 1013413657 |
|---|---|
| Provider Enumeration Date | 04/03/2018 |
| Last Update Date | 08/16/2024 |
| Certification Date | 08/16/2024 |
| Medicare PECOS PAC ID | 0446515092 |
|---|---|
| Medicare Enrollment ID | O20180803000005 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013413657 | NPI | - | NPPES |
| 1548793235 | Medicaid | WI | |
| 1720477182 | Medicaid | WI | |
| K400340967 | Medicaid | WI | |
| 1184002560 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Becca L Greub |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1720477185 PECOS PAC ID: 9032425848 Enrollment ID: I20160105001482 |
Koplitz Mental Health Counseling Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 800 Industrial Ave, Owen, WI 54460 Phone: 715-797-3819 |