| Mainstreet Counseling | |
|
1717 11th St Monroe WI 53566-1839 | |
| (608) 214-6225 | |
| Not Available |
| Full Name | Mainstreet Counseling |
|---|---|
| Speciality | Clinic/Center |
| Location | 1717 11th St, Monroe, Wisconsin |
| Authorized Official Name and Position | Suzanne Kay Koch (PART OWNER) |
| Authorized Official Contact | 6082146225 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mainstreet Counseling 714 21st Ave Monroe WI 53566-1667 Ph: (608) 214-6225 | Mainstreet Counseling 1717 11th St Monroe WI 53566-1839 Ph: (608) 214-6225 |
| NPI Number | 1386283034 |
|---|---|
| Provider Enumeration Date | 12/29/2019 |
| Last Update Date | 12/29/2019 |
| Certification Date | 12/29/2019 |
| Medicare PECOS PAC ID | 4789015454 |
|---|---|
| Medicare Enrollment ID | O20200513000667 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386283034 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Suzanne K Koch |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861581209 PECOS PAC ID: 2163521865 Enrollment ID: I20191001001141 |
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