MEDICARE: ARBOR MENTAL HEALTH CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	101YP2500X	Professional Counselor
2	103TC1900X	Counseling Psychologist
3	103TC0700X	Clinical Psychologist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366065351
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARBOR MENTAL HEALTH CENTER

Provider Business Mailing Address
First Line	:	500 N 3RD ST STE 220
Second Line	:
City	:	WAUSAU
State	:	WI
Zip	:	54403-4857
Country	:	US
Telephone Number	:	715-204-4260
Fax Number	:

Provider Business Practice Location Address
First Line	:	500 N 3RD ST STE 22O
Second Line	:
City	:	WAUSAU
State	:	WI
Zip	:	54403-4885
Country	:	US
Telephone Number	:	715-204-4260
Fax Number	:

Authorized Official
Title or Position	:	CEO/OWNER
Name	:	KRISTINA M. MAUK
Credential	:
Telephone Number	:	715-575-1421

Provider Enumeration Date	:	05/25/2020
Last Update Date	:	01/10/2023

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