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General NPI Number Information
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NPI Number | 1376383455
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Entity Type | Organization
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Legal Business Name | OPEN BOOK COUNSELING WI
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Dates
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Enumeration Date | 05/28/2024
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Last Update Date | 03/12/2025
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Provider Practice Location Address
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Address Line | 405 E FOREST ST
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City | OCONOMWOC
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State | WI
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Zip | 53066
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Country | US
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Telephone | 262-290-6438
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Fax |
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Provider Business Mailing Address
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Address Line | 405 E FOREST ST
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City | OCONOMWOC
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State | WI
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Zip | 53066
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Country | US
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Telephone | 262-290-6438
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Fax |
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Authorized Official
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Title or Position | LPC-IT
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Name | KATELYN PROUTY
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Credential | LPC-IT
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Telephone | 262-290-6438
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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 |
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License Number State |
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