Healthcare Provider Details

I. General information

NPI: 1811834997
Provider Name (Legal Business Name): WISEMIND THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 KING ST STE 106
LA CROSSE WI
54601-4062
US

IV. Provider business mailing address

505 KING ST STE 106
LA CROSSE WI
54601-4062
US

V. Phone/Fax

Practice location:
  • Phone: 608-386-3517
  • Fax:
Mailing address:
  • Phone: 608-386-3517
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: ASHLEY GRIMSLED
Title or Position: OWNER/THERAPIST
Credential: MS, LPC
Phone: 608-386-3517