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General NPI Number Information
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NPI Number | 1962544353
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Entity Type | Organization
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Legal Business Name | SAMARITAN COUNSELING CENTER OF SOUTHERN WISCONSIN INC
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Dates
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Enumeration Date | 02/13/2007
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Last Update Date | 05/20/2025
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Provider Practice Location Address
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Address Line | 5900 MONONA DR STE 100
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City | MONONA
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State | WI
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Zip | 53716-3556
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Country | US
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Telephone | 608-663-0763
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Fax | 608-663-0765
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Provider Business Mailing Address
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Address Line | 5900 MONONA DR STE 100
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City | MONONA
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State | WI
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Zip | 53716-3556
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Country | US
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Telephone | 608-663-0763
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Fax | 608-663-0765
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | ANGELA LAUFENBERG
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Credential |
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Telephone | 608-663-0763
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | HFS 61.91
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License Number State | WI
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Taxonomy #2
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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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