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General NPI Number Information
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NPI Number | 1497828735
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Entity Type | Organization
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Legal Business Name | LUTHERAN COUNSELING & FAMILY SERVICES
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Dates
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Enumeration Date | 11/16/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 601 FALL ST
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City | EAU CLAIRE
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State | WI
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Zip | 54703-3157
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Country | US
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Telephone | 715-524-4840
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Fax | 715-524-4236
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Provider Business Mailing Address
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Address Line | 601 FALL ST
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City | EAU CLAIRE
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State | WI
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Zip | 54703-3157
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Country | US
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Telephone | 715-524-4840
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Fax | 715-524-4236
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DR. CHUCK MESECK
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Credential | PSY.D
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Telephone | 14145368333
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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 | 2211125
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License Number State | WI
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