Healthcare Provider Details

I. General information

NPI: 1649829193
Provider Name (Legal Business Name): CLEAR HARBOR COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2019
Last Update Date: 04/29/2025
Certification Date: 04/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1627 N 34TH ST STE 100
SUPERIOR WI
54880-4478
US

IV. Provider business mailing address

PO BOX 428
SOLON SPRINGS WI
54873-0428
US

V. Phone/Fax

Practice location:
  • Phone: 715-342-9002
  • Fax: 715-312-2009
Mailing address:
  • Phone: 715-342-9002
  • 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 Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: ELIZABETH BYLER
Title or Position: DIRECTOR
Credential: MA, LPC-SAS, LPCC, I
Phone: 715-342-9002