=====================================================
General NPI Number Information
=====================================================
NPI Number | 1245104355
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WOODFIRE COUNSELING LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/01/2025
-----------------------------------------------------
Last Update Date | 10/01/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5900 MONONA DR STE 305
-----------------------------------------------------
City | MONONA
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 53716-3561
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 608-218-4063
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5900 MONONA DR STE 305
-----------------------------------------------------
City | MONONA
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 53716-3561
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 608-218-4063
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | KAYLA EASLAND
-----------------------------------------------------
Credential | LMFT
-----------------------------------------------------
Telephone | 608-218-4063
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------