Healthcare Provider Details

I. General information

NPI: 1871036228
Provider Name (Legal Business Name): DANIEL JAMES CRUGER LCSW,CSAC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/02/2016
Last Update Date: 02/26/2024
Certification Date: 02/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3410 OAKWOOD MALL DR STE 700
EAU CLAIRE WI
54701-2617
US

IV. Provider business mailing address

301 COMFORTCOVE ST
ORFORDVILLE WI
53576-8780
US

V. Phone/Fax

Practice location:
  • Phone: 715-832-1678
  • Fax: 715-832-6680
Mailing address:
  • Phone: 608-800-2766
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number17162-130
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number11506-123
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: