Healthcare Provider Details

I. General information

NPI: 1770599078
Provider Name (Legal Business Name): UPLANDS COUNSELING ASSOCIATES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 11/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1118 PROFESSIONAL DR
DODGEVILLE WI
53533-1176
US

IV. Provider business mailing address

1118 PROFESSIONAL DR
DODGEVILLE WI
53533-1176
US

V. Phone/Fax

Practice location:
  • Phone: 608-935-2838
  • Fax: 608-935-9227
Mailing address:
  • Phone: 608-935-2838
  • Fax: 608-935-9227

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: DR. JEAN ANN WARRIOR
Title or Position: SHAREHOLDER/VICE PRESIDENT
Credential: PH.D.
Phone: 608-935-2838