Healthcare Provider Details

I. General information

NPI: 1437085875
Provider Name (Legal Business Name): WIREBAUGH THERAPY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

984 HASTINGS CT
RACINE WI
53406-7007
US

IV. Provider business mailing address

984 HASTINGS CT
RACINE WI
53406-7007
US

V. Phone/Fax

Practice location:
  • Phone: 414-544-5935
  • Fax:
Mailing address:
  • Phone: 414-544-5935
  • 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: DAWN MARIE WIREBAUGH
Title or Position: CLINICAL THERAPIST
Credential: LPC, SAC
Phone: 414-554-5935