Healthcare Provider Details

I. General information

NPI: 1720969850
Provider Name (Legal Business Name): WOVEN PATH COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2025
Last Update Date: 09/08/2025
Certification Date: 09/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5303 E JELINEK AVE STE A
WESTON WI
54476-4230
US

IV. Provider business mailing address

2135 OREGON TRL
KRONENWETTER WI
54455-7236
US

V. Phone/Fax

Practice location:
  • Phone: 715-571-3915
  • Fax:
Mailing address:
  • Phone: 715-571-3915
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: AMY L ABEL
Title or Position: LICENSED CLINICAL SOCIAL WORKER
Credential: LCSW
Phone: 715-571-3915