| Northern Woods Wellness Llc | |
|
1235a Menomonie St Eau Claire WI 54703-5974 | |
| (715) 598-1568 | |
| (715) 800-0104 |
| Full Name | Northern Woods Wellness Llc |
|---|---|
| Speciality | Counselor |
| Location | 1235a Menomonie St, Eau Claire, Wisconsin |
| Authorized Official Name and Position | Timothy Ryan Foster (OWNER/THERAPIST) |
| Authorized Official Contact | 7156001966 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northern Woods Wellness Llc 1235a Menomonie St Eau Claire WI 54703-5974 Ph: (715) 598-1568 | Northern Woods Wellness Llc 1235a Menomonie St Eau Claire WI 54703-5974 Ph: (715) 598-1568 |
| NPI Number | 1285447292 |
|---|---|
| Provider Enumeration Date | 01/31/2025 |
| Last Update Date | 07/03/2025 |
| Certification Date | 07/03/2025 |
| Medicare PECOS PAC ID | 6901328558 |
|---|---|
| Medicare Enrollment ID | O20250324002055 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285447292 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Kelly Szozda Swartos |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033876602 PECOS PAC ID: 1153713953 Enrollment ID: I20220127001114 |
| Provider Name | Tara L Thiele |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1720625049 PECOS PAC ID: 0749623007 Enrollment ID: I20240205000346 |
| Provider Name | Timothy Ryan Foster |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1982148722 PECOS PAC ID: 3870936305 Enrollment ID: I20240212001985 |
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