Healthcare Provider Details

I. General information

NPI: 1578617320
Provider Name (Legal Business Name): WETZEL-RASMUSSEN COUNSELING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 01/17/2023
Certification Date: 01/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

W10610 CLINIC ST.
ELCHO WI
54428-0278
US

IV. Provider business mailing address

W10610 CLINIC STREET PO BOX 278
ELCHO WI
54428-0278
US

V. Phone/Fax

Practice location:
  • Phone: 715-275-3934
  • Fax: 715-275-4533
Mailing address:
  • Phone: 715-275-3934
  • Fax: 715-275-4510

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number3361125
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number35255020
License Number StateWI

VIII. Authorized Official

Name: MRS. NATALIE ANN WETZEL RASMUSSEN
Title or Position: OWNER LICENSED PROFESSIONAL COUNSEL
Credential: MA LPC
Phone: 715-275-3934