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General NPI Number Information
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NPI Number | 1235646647
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Entity Type | Organization
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Legal Business Name | ABEGGLEN COUNSELING AND CONSULTING, LLC
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Dates
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Enumeration Date | 01/08/2018
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Last Update Date | 07/22/2024
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Provider Practice Location Address
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Address Line | 2920 MARKETPLACE DR STE 203
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City | FITCHBURG
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State | WI
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Zip | 53719-5338
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Country | US
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Telephone | 608-709-9672
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Fax | 608-416-1535
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Provider Business Mailing Address
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Address Line | 2976 TRIVERTON PIKE DR STE 110
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City | FITCHBURG
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State | WI
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Zip | 53711-5840
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Country | US
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Telephone | 608-445-6064
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Fax | 608-298-3288
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Authorized Official
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Title or Position | OWNER
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Name | JESSICA MARIE-LYNCH ABEGGLEN
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Credential | LPC
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Telephone | 608-445-6064
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 5355-125
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License Number State | WI
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