Healthcare Provider Details

I. General information

NPI: 1669188405
Provider Name (Legal Business Name): APPLE GROVE COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2023
Last Update Date: 08/12/2025
Certification Date: 08/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1708 BARTON AVE
WEST BEND WI
53090-1906
US

IV. Provider business mailing address

1708 BARTON AVE
WEST BEND WI
53090-1906
US

V. Phone/Fax

Practice location:
  • Phone: 262-355-8290
  • Fax: 262-299-5501
Mailing address:
  • Phone: 262-355-8290
  • Fax: 262-299-5501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name: EMILY LOUISE BOETTCHER
Title or Position: COUNSELOR
Credential: LPC
Phone: 262-355-8290