Healthcare Provider Details

I. General information

NPI: 1467390344
Provider Name (Legal Business Name): COURAGE TO GROW COUNSELING CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1052 OAK FOREST DR STE 190
ONALASKA WI
54650-3705
US

IV. Provider business mailing address

1052 OAK FOREST DR STE 190
ONALASKA WI
54650-3705
US

V. Phone/Fax

Practice location:
  • Phone: 507-884-1497
  • Fax:
Mailing address:
  • Phone: 507-884-1497
  • 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: ANDREA WAGNER
Title or Position: MENTAL HEALTH THERAPIST
Credential: MED
Phone: 507-884-1497