| Northwest Counseling & Guidance Clinic | |
|
203 United Way Drive Frederic WI 54837-8938 | |
| (715) 327-4402 | |
| (715) 327-4470 |
| Full Name | Northwest Counseling & Guidance Clinic |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 203 United Way Drive, Frederic, Wisconsin |
| Authorized Official Name and Position | Jackie J Maurer (BUSINESS OFFICE SUPERVISOR) |
| Authorized Official Contact | 7153274322 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northwest Counseling & Guidance Clinic 203 United Way Drive Frederic WI 54837-8938 Ph: (715) 327-4322 | Northwest Counseling & Guidance Clinic 203 United Way Drive Frederic WI 54837-8938 Ph: (715) 327-4402 |
| NPI Number | 1104990530 |
|---|---|
| Provider Enumeration Date | 11/18/2006 |
| Last Update Date | 03/27/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104990530 | NPI | - | NPPES |
| 42626 | Other | MN | HEALTH PARTNERS |
| 7H956NO | Other | MN | BCBS OF MN |
| 85575 | Other | MN | PREFERRED ONE |
| 42214000 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 2254 (Wisconsin) | Primary |
Hope Road Wellness Center, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 107 Hope Road West, Frederic, WI 54837 Phone: 715-491-5365 Fax: 800-684-2131 |