Healthcare Provider Details

I. General information

NPI: 1386836179
Provider Name (Legal Business Name): SMS COUNSELING SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2007
Last Update Date: 08/15/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

927A SOUTH 8TH STREET SUITE 300
MANITOWOC WI
54220-4542
US

IV. Provider business mailing address

927A SOUTH 8TH STREET SUITE 300
MANITOWOC WI
54220-4542
US

V. Phone/Fax

Practice location:
  • Phone: 920-684-6644
  • Fax: 920-684-1110
Mailing address:
  • Phone: 920-684-6644
  • Fax: 920-684-1110

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number290 123
License Number StateWI

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MRS. SUSAN MARIE SCHUTZ
Title or Position: LICENSED INDEPENDENT CLINICAL SOCIA
Credential: LICSW
Phone: 920-684-6644