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General NPI Number Information
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NPI Number | 1922804657
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Entity Type | Organization
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Legal Business Name | GOING FORWARD BEHAVIOR COACHING
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Dates
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Enumeration Date | 02/24/2025
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Last Update Date | 02/24/2025
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Provider Practice Location Address
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Address Line | N8135 CAMBRIAN RD
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City | HOLMEN
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State | WI
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Zip | 54636-9279
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Country | US
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Telephone | 608-317-8574
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 144
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City | HOLMEN
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State | WI
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Zip | 54636-0144
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Country | US
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Telephone | 608-317-8574
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | LINDSAY SUE KELLY STREY
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Credential | MA, BCBA, LBA, CHWC
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Telephone | 608-317-8574
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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 |
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License Number State |
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