| NPI | 1659447704 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM HOLLINGSWORTH Clinic Director, Owner 608-755-1475 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WI 1448) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 1448) |
| 103T00000X Psychologist (Licence: WI 1448) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: WI 1448) | |
| 1041C0700X Social Worker, Clinical (Licence: WI 1448) | |
| 106H00000X Marriage & Family Therapist (Licence: WI 1448) | |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2015-11-02 |