Healthcare Provider Details

I. General information

NPI: 1821011545
Provider Name (Legal Business Name): JOURNEY POINTS THERAPY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 06/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 3RD AVE SUITE 110
OSCEOLA WI
54020
US

IV. Provider business mailing address

PO BOX 217
SOMERSET WI
54025-0217
US

V. Phone/Fax

Practice location:
  • Phone: 715-294-3567
  • Fax: 715-247-2802
Mailing address:
  • Phone: 715-247-2802
  • Fax: 715-247-2802

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number660-124
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number660-124
License Number StateWI

VIII. Authorized Official

Name: MRS. LISA JO WEBER SEDLAK
Title or Position: MARRIAGE AND FAMILY THERAPIST
Credential: MS
Phone: 715-247-2802