| Nicklaus Counseling Center Sc | |
|
1557 Cleveland Ave Marinette WI 54143-3920 | |
| (715) 732-6868 | |
| (715) 732-6866 |
| Full Name | Nicklaus Counseling Center Sc |
|---|---|
| Speciality | Counselor |
| Location | 1557 Cleveland Ave, Marinette, Wisconsin |
| Authorized Official Name and Position | Christine Nicklaus (OWNER) |
| Authorized Official Contact | 7157326868 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Nicklaus Counseling Center Sc 1557 Cleveland Ave Marinette WI 54143-3920 Ph: (715) 732-6868 | Nicklaus Counseling Center Sc 1557 Cleveland Ave Marinette WI 54143-3920 Ph: (715) 732-6868 |
| NPI Number | 1033659271 |
|---|---|
| Provider Enumeration Date | 03/07/2017 |
| Last Update Date | 06/20/2024 |
| Certification Date | 06/20/2024 |
| Medicare PECOS PAC ID | 7618411315 |
|---|---|
| Medicare Enrollment ID | O20240705001922 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033659271 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 2992-226 (Wisconsin) | Primary |
| Provider Name | Debra A Mullen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770660342 PECOS PAC ID: 5991987745 Enrollment ID: I20110315000776 |
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