Provider Demographics
NPI:1093496283
Name:MY TIME COUNSELING SERVICES, INC.
Entity Type:Organization
Organization Name:MY TIME COUNSELING SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SELENA
Authorized Official - Middle Name:L
Authorized Official - Last Name:LETTEER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, CSAC, ICS
Authorized Official - Phone:608-561-8656
Mailing Address - Street 1:7957 W WIND LAKE RD STE E
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:WI
Mailing Address - Zip Code:53185-2234
Mailing Address - Country:US
Mailing Address - Phone:608-561-8656
Mailing Address - Fax:
Practice Address - Street 1:7957 W WIND LAKE RD STE E
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:WI
Practice Address - Zip Code:53185-2234
Practice Address - Country:US
Practice Address - Phone:608-561-8656
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-31
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty