Healthcare Provider Details

I. General information

NPI: 1417218223
Provider Name (Legal Business Name): CARING PATH COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2012
Last Update Date: 02/03/2025
Certification Date: 01/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6580 MONONA DR # 1011
MONONA WI
53716-4032
US

IV. Provider business mailing address

6580 MONONA DR # 1011
MONONA WI
53716-4032
US

V. Phone/Fax

Practice location:
  • Phone: 651-200-8788
  • Fax:
Mailing address:
  • Phone: 651-200-8788
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number17750
License Number StateMN

VIII. Authorized Official

Name: JUSTIN DAVID LESS
Title or Position: LICSW/OWNER
Credential:
Phone: 651-200-8788