Provider Type Icon

BLUE WATERS FAMILY COUNSELING S.C. NPI 1366556359


NPI Information

NPI: 1366556359
Provider Name: BLUE WATERS FAMILY COUNSELING, S.C.
Classification: Counselor - 101Y00000X
Entity Type: Organization
Address:
2215 WASHINGTON ST
MANITOWOC, WI
ZIP 54220
Phone: (920) 683-3911
Get Directions

BLUE WATERS FAMILY COUNSELING, S.C. is a counselor in Manitowoc, WI. The provider is a provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification. BLUE WATERS FAMILY COUNSELING, S.C. NPI is 1366556359. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

2215 WASHINGTON ST
MANITOWOC, WI
ZIP 54220-847
Phone: (920) 683-3911
Fax: (920) 683-3411

The provider's authorized official is Diane M Berry .
The authorized official title is Director and has the following contact phone number (920) 683-3911.

The enumeration date for this NPI number is 8/18/2006 and was last updated on 2/8/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101Y00000XCounselorYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
142217300MEDICAIDWISCONSIN
2000044375MEDICARE PINWISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.