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NPI 1821858721

NPI 1821858721 : HERITAGE MENTAL WELLNESS, LLC : EAU CLAIRE, WI

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General NPI Number Information
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    NPI Number           |    1821858721
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    Entity Type          |    Organization 
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    Legal Business Name  |    HERITAGE MENTAL WELLNESS, LLC 
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Dates
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    Enumeration Date     |    03/20/2024
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    Last Update Date     |    09/16/2025
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Provider Practice Location Address
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    Address Line         |    1231 MENOMONIE ST STE A 
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    City                 |    EAU CLAIRE
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    State                |    WI
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    Zip                  |    54703-6336
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    Country              |    US
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    Telephone            |    715-271-0064
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2803 HEMLOCK LN 
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    City                 |    EAU CLAIRE
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    State                |    WI
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    Zip                  |    54703-1219
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    Country              |    US
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    Telephone            |    715-271-0064
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     EMILY F STEPHENSON 
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    Credential           |    LMFT
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    Telephone            |    715-271-0064
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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