=====================================================
General NPI Number Information
=====================================================
NPI Number | 1720969850
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WOVEN PATH COUNSELING LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/08/2025
-----------------------------------------------------
Last Update Date | 09/08/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5303 E JELINEK AVE STE A
-----------------------------------------------------
City | WESTON
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 54476-4230
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 715-571-3915
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2135 OREGON TRL
-----------------------------------------------------
City | KRONENWETTER
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 54455-7236
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 715-571-3915
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | LICENSED CLINICAL SOCIAL WORKER
-----------------------------------------------------
Name | AMY L ABEL
-----------------------------------------------------
Credential | LCSW
-----------------------------------------------------
Telephone | 715-571-3915
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------