Healthcare Provider Details

I. General information

NPI: 1841466448
Provider Name (Legal Business Name): MARRIAGE & FAMILY HEALTH SERVICES, LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2008
Last Update Date: 05/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 ISLAND ST
CHIPPEWA FALLS WI
54729-2324
US

IV. Provider business mailing address

2925 MONDOVI RD
EAU CLAIRE WI
54701-6141
US

V. Phone/Fax

Practice location:
  • Phone: 715-832-0238
  • Fax: 715-832-0771
Mailing address:
  • Phone: 715-832-0238
  • Fax: 715-832-0771

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: DR. THOMAS E JOHNSTON
Title or Position: DIRECTOR/OWNER
Credential: PHD
Phone: 715-832-0238