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General NPI Number Information
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NPI Number | 1588370308
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Entity Type | Organization
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Legal Business Name | ENGAGE COUNSELING AND CONSULTATION LLC
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Dates
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Enumeration Date | 01/25/2023
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Last Update Date | 01/25/2023
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Provider Practice Location Address
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Address Line | 3701 E EVERGREEN DR STE 240
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City | APPLETON
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State | WI
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Zip | 54913-7409
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Country | US
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Telephone | 925-639-3666
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Fax | 800-813-9164
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Provider Business Mailing Address
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Address Line | N7868 LAKESHORE LN
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City | SHERWOOD
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State | WI
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Zip | 54169-9633
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Country | US
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Telephone | 925-639-3666
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Fax |
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | HART MEYRICH
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Credential |
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Telephone | 407-340-9039
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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