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General NPI Number Information
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NPI Number | 1538814959
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Entity Type | Organization
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Legal Business Name | DEY COUNSELING SERVICE LLC
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Dates
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Enumeration Date | 02/14/2022
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Last Update Date | 02/15/2022
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Provider Practice Location Address
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Address Line | 2301 RIVERSIDE DR STE B11
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City | GREEN BAY
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State | WI
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Zip | 54301-1957
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Country | US
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Telephone | 920-544-6818
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Fax | 920-212-4997
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Provider Business Mailing Address
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Address Line | 2417 MANITOWOC RD
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City | GREEN BAY
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State | WI
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Zip | 54311-5323
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Country | US
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Telephone | 920-544-6818
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Fax | 920-212-4997
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Authorized Official
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Title or Position | OWNER/CLINICIAN
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Name | MS. BROOKE MARNIE DEY
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Credential | LPC
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Telephone | 920-544-6818
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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