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General NPI Number Information
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NPI Number | 1770937203
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Entity Type | Organization
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Legal Business Name | PALADIN COUNSELING & CONSULTATION, LLC
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Dates
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Enumeration Date | 04/21/2016
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Last Update Date | 04/21/2016
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Provider Practice Location Address
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Address Line | 819 1ST AVE
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City | MONROE
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State | WI
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Zip | 53566-3806
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Country | US
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Telephone | 608-325-5520
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Fax | 608-325-5846
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Provider Business Mailing Address
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Address Line | PO BOX 708 819 1ST AVE
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City | MONROE
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State | WI
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Zip | 53566
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Country | US
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Telephone | 608-325-5520
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Fax | 608-325-5846
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Authorized Official
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Title or Position | OWNER
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Name | LAURA R PLACEK
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Credential | LPC SAC CSACIT
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Telephone | 608-325-5520
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 1556226
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License Number State | WI
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