Provider Demographics
NPI:1093990822
Name:COUNSELING ASSOCIATES OF ST. CROIX, INC
Entity Type:Organization
Organization Name:COUNSELING ASSOCIATES OF ST. CROIX, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:KLEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-483-3544
Mailing Address - Street 1:809 US HWY 8 EAST
Mailing Address - Street 2:PO BOX 606
Mailing Address - City:ST. CROIX FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:54024
Mailing Address - Country:US
Mailing Address - Phone:715-483-3544
Mailing Address - Fax:715-483-3741
Practice Address - Street 1:809 US HWY 8 EAST
Practice Address - Street 2:
Practice Address - City:ST. CROIX FALLS
Practice Address - State:WI
Practice Address - Zip Code:54024
Practice Address - Country:US
Practice Address - Phone:715-483-3544
Practice Address - Fax:715-483-3741
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-28
Last Update Date:2007-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI42183400Medicaid