Healthcare Provider Details

I. General information

NPI: 1396657920
Provider Name (Legal Business Name): ORB MENTAL HEALTH COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 BELKNAP ST
SUPERIOR WI
54880-2933
US

IV. Provider business mailing address

PO BOX 841
SUPERIOR WI
54880-0841
US

V. Phone/Fax

Practice location:
  • Phone: 218-556-4736
  • Fax:
Mailing address:
  • Phone:
  • 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: NOLAN EWERT
Title or Position: OWNER
Credential: LPCC
Phone: 218-556-4736