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General NPI Number Information
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NPI Number | 1275281909
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Entity Type | Organization
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Legal Business Name | LOOKING GLASS COUNSELING, LLC
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Dates
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Enumeration Date | 03/11/2022
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Last Update Date | 03/11/2022
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Provider Practice Location Address
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Address Line | 404 N MAIN ST STE 512
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City | OSHKOSH
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State | WI
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Zip | 54901-4952
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Country | US
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Telephone | 920-267-0137
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Fax | 920-232-1395
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Provider Business Mailing Address
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Address Line | 404 N MAIN ST STE 512
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City | OSHKOSH
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State | WI
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Zip | 54901-4952
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Country | US
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Telephone | 920-267-0137
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Fax |
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Authorized Official
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Title or Position | OWNER/PSCYHOTHERAPIST
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Name | MS. NICOLE ANN MILLERD
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Credential | MSW, LCSW
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Telephone | 920-267-0137
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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