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General NPI Number Information
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NPI Number | 1982374344
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Entity Type | Organization
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Legal Business Name | DRIFTLESS AREA BEHAVIORAL SERVICES, LLC
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Dates
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Enumeration Date | 09/16/2021
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Last Update Date | 01/05/2026
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Provider Practice Location Address
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Address Line | 1250 E BUSINESS HIGHWAY 151 STE D
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City | PLATTEVILLE
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State | WI
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Zip | 53818-3875
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Country | US
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Telephone | 608-470-2200
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 632
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City | PLATTEVILLE
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State | WI
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Zip | 53818-0632
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Country | US
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Telephone | 608-470-2200
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | STACEY RICHARD-BAAL
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Credential | MSW, LCSW
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Telephone | 563-581-2064
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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