Healthcare Provider Details

I. General information

NPI: 1194644278
Provider Name (Legal Business Name): CHIPPEWA VALLEY INDEPENDENT PSYCHIATRY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2829 COUNTY HIGHWAY I STE 3G
CHIPPEWA FALLS WI
54729-2678
US

IV. Provider business mailing address

2829 COUNTY HIGHWAY I STE 3G
CHIPPEWA FALLS WI
54729-2678
US

V. Phone/Fax

Practice location:
  • Phone: 715-597-7192
  • Fax:
Mailing address:
  • Phone: 715-597-7192
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MR. STEVEN ARMSTRONG HENDERSON
Title or Position: MANAGING MEMBER/PROVIDER
Credential: APNP, PMHNP-BC
Phone: 715-597-7192