| Stonehouse Counseling, Llc | |
|
414 S East Ave Viroqua WI 54665 | |
| (608) 638-3332 | |
| (608) 637-7328 |
| Full Name | Stonehouse Counseling, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 414 S East Ave, Viroqua, Wisconsin |
| Authorized Official Name and Position | Susan Kopp Townsley (DIRECTOR) |
| Authorized Official Contact | 6086383332 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Stonehouse Counseling, Llc 414 S East Ave Viroqua WI 54665-2006 Ph: (608) 638-3332 | Stonehouse Counseling, Llc 414 S East Ave Viroqua WI 54665 Ph: (608) 638-3332 |
| NPI Number | 1588837074 |
|---|---|
| Provider Enumeration Date | 04/07/2008 |
| Last Update Date | 06/15/2018 |
| Medicare PECOS PAC ID | 0042569923 |
|---|---|
| Medicare Enrollment ID | O20180827001338 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588837074 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 6737123 (Wisconsin) | Primary |
| Provider Name | Jessica M Wallace |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1932855871 PECOS PAC ID: 3971949603 Enrollment ID: I20240315002043 |
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