Healthcare Provider Details

I. General information

NPI: 1558977991
Provider Name (Legal Business Name): GUIDED SOLUTIONS THERAPY SC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2020
Last Update Date: 08/17/2023
Certification Date: 08/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

134 W HOLUM ST
DEFOREST WI
53532-1108
US

IV. Provider business mailing address

134 W HOLUM ST
DEFOREST WI
53532-1108
US

V. Phone/Fax

Practice location:
  • Phone: 608-620-5126
  • Fax:
Mailing address:
  • Phone: 608-620-5126
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: AMY LYNN HOFFMANN
Title or Position: PROVIDER/OWNER/MEMBER
Credential: LCSW, SAC
Phone: 608-347-5551