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General NPI Number Information
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NPI Number | 1497347827
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Entity Type | Organization
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Legal Business Name | SOLID GROUND COUNSELING LLC
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Dates
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Enumeration Date | 02/08/2021
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Last Update Date | 02/08/2021
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Provider Practice Location Address
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Address Line | 15792 W WOLF LN
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City | HAYWARD
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State | WI
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Zip | 54843-6553
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Country | US
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Telephone | 715-634-2575
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 6
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City | HAYWARD
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State | WI
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Zip | 54843-0006
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Country | US
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Telephone | 715-634-2575
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CONNIE J MOHAWK
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Credential | LPC
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Telephone | 715-634-2575
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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