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General NPI Number Information
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NPI Number | 1639402902
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Entity Type | Organization
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Legal Business Name | INNERVISIONS COUNSELING & CONSULTING CENTER, S.C.
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Dates
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Enumeration Date | 09/17/2009
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Last Update Date | 01/09/2023
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Provider Practice Location Address
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Address Line | 840 STATE ROAD 136 STE 1
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City | BARABOO
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State | WI
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Zip | 53913-9252
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Country | US
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Telephone | 608-477-9858
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Fax | 877-560-0578
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Provider Business Mailing Address
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Address Line | 840 STATE ROAD 136 STE 1
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City | BARABOO
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State | WI
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Zip | 53913-9252
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Country | US
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Telephone | 608-477-9858
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Fax | 877-560-0578
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. COLLEEN SUZANNA JAMES
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Credential | LPC, LCSW, CSAC
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Telephone | 608-477-9858
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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 | 133
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License Number State | WI
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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 | #2
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | #123
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License Number State | WI
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Taxonomy #4
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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