Healthcare Provider Details

I. General information

NPI: 1568123560
Provider Name (Legal Business Name): EXPANDING HOPE COUNSELING SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2022
Last Update Date: 06/17/2024
Certification Date: 06/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1062 OAK FOREST DR STE 120
ONALASKA WI
54650-3501
US

IV. Provider business mailing address

1062 OAK FOREST DR STE 120
ONALASKA WI
54650-3501
US

V. Phone/Fax

Practice location:
  • Phone: 608-790-9481
  • Fax: 608-790-9480
Mailing address:
  • Phone: 608-790-9481
  • Fax: 608-790-9480

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: NANCY LOUISE MILLER
Title or Position: OWNER/PSYCHOTHERAPIST
Credential: LPC
Phone: 608-790-9481