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General NPI Number Information
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NPI Number | 1710986989
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Entity Type | Organization
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Legal Business Name | FAMILY SERVICE OF WINONA
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Dates
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Enumeration Date | 07/19/2005
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 66 E. 3RD STREET #201
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City | WINONA
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State | MN
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Zip | 55987
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Country | US
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Telephone | 507-462-7292
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Fax | 507-457-9887
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Provider Business Mailing Address
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Address Line | 66 E. 3RD STREET #201
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City | WINONA
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State | MN
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Zip | 55987
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Country | US
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Telephone | 507-462-7292
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Fax | 507-457-9887
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Authorized Official
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Title or Position | ADMIN MANAGER/THERAPIST
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Name | MS. DIANE V. PETZ
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Credential | MS/LP
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Telephone | 507-452-7292
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 8677
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 8882
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | LP4439
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License Number State | MN
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Taxonomy #4
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | LP4392
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License Number State | MN
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Taxonomy #5
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | LP1219
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License Number State | MN
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Taxonomy #6
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | LP3132
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License Number State | MN
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Taxonomy #7
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | LP0177
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License Number State | MN
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