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NPI Code Detail

MEDICARE: GUY W SHILTS III LPC

MEDICARE: GUY W SHILTS III LPC
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor5826WI
2101Y00000XCounselor1871-226WI

General Provider Information

NPI Number : 1609202035
Entity Type Code : Individual
Provider Name (Legal Business Name) : GUY W SHILTS III LPC
Provider Business Mailing Address
First Line : 17 S. RIVER ST.
Second Line : SUITE 254
City : JANESVILLE
State : WI
Zip : 53548-3863
Country : US
Telephone Number : 608-755-5260
Fax Number : 608-755-5267
Provider Business Practice Location Address
First Line : 17 S. RIVER ST.
Second Line : SUITE 254
City : JANESVILLE
State : WI
Zip : 53548-3863
Country : US
Telephone Number : 608-755-5260
Fax Number : 608-755-5267
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/17/2013
Last Update Date : 07/26/2016

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Directions to “ GUY W SHILTS III LPC” Practice Location

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