| Reflection, Llc | |
|
1620 S Lawe St Ste 5 Appleton WI 54915-2400 | |
| (920) 284-9676 | |
| (920) 481-3121 |
| Full Name | Reflection, Llc |
|---|---|
| Speciality | Counselor |
| Location | 1620 S Lawe St Ste 5, Appleton, Wisconsin |
| Authorized Official Name and Position | Larissa Fravel (OWNER) |
| Authorized Official Contact | 9209150102 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Reflection, Llc 1620 S Lawe St Ste 5 Appleton WI 54915-2400 Ph: (920) 284-9676 | Reflection, Llc 1620 S Lawe St Ste 5 Appleton WI 54915-2400 Ph: (920) 284-9676 |
| NPI Number | 1588323893 |
|---|---|
| Provider Enumeration Date | 12/14/2021 |
| Last Update Date | 12/14/2021 |
| Certification Date | 12/14/2021 |
| Medicare PECOS PAC ID | 0042654915 |
|---|---|
| Medicare Enrollment ID | O20240219002996 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588323893 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Steven Fricke |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1679133912 PECOS PAC ID: 9032553904 Enrollment ID: I20240219003041 |
| Provider Name | Lisa J Cavil |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1538578794 PECOS PAC ID: 8022452903 Enrollment ID: I20240219003104 |
| Provider Name | Larissa Fravel |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1841641586 PECOS PAC ID: 2860836731 Enrollment ID: I20240314001347 |
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