Healthcare Provider Details

I. General information

NPI: 1487563193
Provider Name (Legal Business Name): CHEQUAMEGON COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2026
Last Update Date: 09/07/2026
Certification Date: 09/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 W OMAHA ST
WASHBURN WI
54891-4557
US

IV. Provider business mailing address

21 W OMAHA ST
WASHBURN WI
54891-4557
US

V. Phone/Fax

Practice location:
  • Phone: 715-504-0688
  • Fax: 715-504-0650
Mailing address:
  • Phone: 715-504-0688
  • Fax: 715-504-0650

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name: BRITTANY KUKA
Title or Position: OWNER, THERAPIST
Credential: LPC
Phone: 715-504-0688