| NPI | 1013439371 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE R. JOHNSON Owner & Psychotherapist 608-616-1010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WI 3067-125) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 15560-131) |
| 261QM0850X Clinic/Center, Adult Mental Health (Licence: WI 3067-125) | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: WI 3067-125) | |
| Enumeration Date | 2017-07-08 |
| Last Update Date | 2022-07-21 |