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General NPI Number Information
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NPI Number | 1376460592
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Entity Type | Individual
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Provider Name | CHRISTOPHER SCOTT GOETSCH
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Gender | Male
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Dates
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Enumeration Date | 06/30/2026
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Last Update Date | 06/30/2026
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Provider Practice Location Address
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Address Line | 1191 HUNTINGTON AVE
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City | WISCONSIN RAPIDS
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State | WI
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Zip | 54494-6364
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Country | US
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Telephone | 715-818-6443
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Fax |
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Provider Business Mailing Address
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Address Line | 6320 TIMBERLINE WAY
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City | WISCONSIN RAPIDS
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State | WI
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Zip | 54494-8001
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Country | US
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Telephone | 608-617-5277
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 9016-226
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License Number State | WI
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