Healthcare Provider Details

I. General information

NPI: 1972342103
Provider Name (Legal Business Name): ROCK POINT PSYCHOLOGY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2024
Last Update Date: 08/25/2024
Certification Date: 08/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 N 1ST ST STE 2400
WAUSAU WI
54403-4886
US

IV. Provider business mailing address

500 N 1ST ST STE 2400
WAUSAU WI
54403-4886
US

V. Phone/Fax

Practice location:
  • Phone: 715-322-3581
  • Fax: 715-977-8675
Mailing address:
  • Phone: 715-322-3581
  • Fax: 715-977-8675

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TH0004X
TaxonomyHealth Psychologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. JENNIFER LYNN MICHELS
Title or Position: CLINICAL PSYCHOLOGIST
Credential: PHD
Phone: 715-322-3581