MEDICARE: CHIPPEWA VALLEY COUNSELING CENTER, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist

General Provider Information

NPI Number	:	1013883826
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHIPPEWA VALLEY COUNSELING CENTER, LLC

Provider Business Mailing Address
First Line	:	7350 20TH AVE
Second Line	:
City	:	EAU CLAIRE
State	:	WI
Zip	:	54703-6888
Country	:	US
Telephone Number	:	715-895-7115
Fax Number	:

Provider Business Practice Location Address
First Line	:	2725 MALL DR STE 7
Second Line	:
City	:	EAU CLAIRE
State	:	WI
Zip	:	54701-6835
Country	:	US
Telephone Number	:	715-895-7115
Fax Number	:

Authorized Official
Title or Position	:	PSYCHOLOGIST/OWNER
Name	:	DR. SHAUNA PUTZY
Credential	:	PSYD
Telephone Number	:	715-895-7115

Provider Enumeration Date	:	10/17/2025
Last Update Date	:	06/09/2026

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