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General NPI Number Information
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NPI Number | 1558043711
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Entity Type | Organization
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Legal Business Name | HAFERMANN COUNSELING COLLABORATIVE, LLC
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Dates
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Enumeration Date | 08/07/2023
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Last Update Date | 06/24/2025
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Provider Practice Location Address
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Address Line | 320 W GRAND AVE STE 204
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City | WISCONSIN RAPIDS
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State | WI
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Zip | 54495-2781
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Country | US
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Telephone | 715-421-1107
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Fax | 715-421-1108
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Provider Business Mailing Address
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Address Line | 820 TWO MILE AVE
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City | WISCONSIN RAPIDS
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State | WI
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Zip | 54494-6661
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Country | US
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Telephone | 715-421-1107
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Fax | 715-421-1108
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Authorized Official
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Title or Position | OWNER
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Name | JANELLE HAFERMANN
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Credential | LPC, CSAC, ICS
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Telephone | 715-342-1110
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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