Healthcare Provider Details

I. General information

NPI: 1225583883
Provider Name (Legal Business Name): SUPERIOR COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2016
Last Update Date: 02/16/2025
Certification Date: 02/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10592 MAIN ST
HAYWARD WI
54843-6658
US

IV. Provider business mailing address

PO BOX 1021
HAYWARD WI
54843-1021
US

V. Phone/Fax

Practice location:
  • Phone: 715-416-1381
  • Fax: 715-934-2091
Mailing address:
  • Phone: 715-416-1381
  • Fax: 715-934-2091

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: ELIZABETH JOHNSON
Title or Position: PSYCHOTHERAPIST
Credential: MS, LSC, LPC
Phone: 715-416-1381