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General NPI Number Information
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NPI Number | 1598304412
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Entity Type | Organization
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Legal Business Name | 22 A DAY COUNSELING L.L.C.
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Dates
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Enumeration Date | 12/23/2019
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Last Update Date | 01/11/2020
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Provider Practice Location Address
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Address Line | 2211 E CLAIREMONT AVE STE 2
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City | EAU CLAIRE
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State | WI
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Zip | 54701-4921
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Country | US
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Telephone | 715-598-1865
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Fax | 715-598-1866
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Provider Business Mailing Address
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Address Line | 2211 E CLAIREMONT AVE STE 2
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City | EAU CLAIRE
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State | WI
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Zip | 54701-4921
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Country | US
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Telephone | 715-598-1865
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Fax | 715-598-1866
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Authorized Official
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Title or Position | OWNER
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Name | PAUL NELSON ROADT
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Credential | L.C.S.W, C.S.A.C.
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Telephone | 715-598-1865
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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 |
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License Number State |
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