Healthcare Provider Details

I. General information

NPI: 1093869505
Provider Name (Legal Business Name): FAMILY SERVICES OF SOUTHERN WISCONSIN AND NORTHERN ILLINOIS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 LIBERTY AVE
BELOIT WI
53511-6310
US

IV. Provider business mailing address

825 LIBERTY AVE
BELOIT WI
53511-6310
US

V. Phone/Fax

Practice location:
  • Phone: 608-365-1244
  • Fax: 608-365-4097
Mailing address:
  • Phone: 608-365-1244
  • Fax: 608-365-4097

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MS. JOAN CURTIS
Title or Position: DIRECTOR OF SUPPORTIVE SERVICES
Credential: LPC
Phone: 608-365-1244