FANNIN COUNSELING & ART THERAPY NPI 1730691205

NPI Information

NPI: 1730691205
Provider Name: FANNIN COUNSELING & ART THERAPY
Classification: Counselor - 101YM0800X
Entity Type: Organization

Specialization: Mental Health

Address:
129 6TH ST S
LA CROSSE, WI
ZIP 54601
Phone: (608) 385-7559
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FANNIN COUNSELING & ART THERAPY is a mental health counselor in La Crosse, WI. FANNIN COUNSELING & ART THERAPY NPI is 1730691205. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

129 6TH ST S
LA CROSSE, WI
ZIP 54601-153
Phone: (608) 385-7559

The provider's authorized official is Melissa Fannin .
The authorized official title is Owner/counselor and has the following contact phone number (608) 385-7559.

The enumeration date for this NPI number is 10/24/2017 and was last updated on 10/24/2017.

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
1	101YM0800X	Counselor	Mental Health	5465-125	WISCONSIN	Yes

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
1	12772699	OTHER	WISCONSIN	CAQH
2	100043611	MEDICAID	WISCONSIN

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: 11/14/2023

NPI Synchronization or Removal

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