Provider Demographics
NPI:1104855279
Name:ASSOCIATED COUNSELING SERVICES, INC.
Entity Type:Organization
Organization Name:ASSOCIATED COUNSELING SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:J
Authorized Official - Last Name:WESLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPC
Authorized Official - Phone:715-848-3031
Mailing Address - Street 1:PO BOX 1721
Mailing Address - Street 2:
Mailing Address - City:WAUSAU
Mailing Address - State:WI
Mailing Address - Zip Code:54402-1721
Mailing Address - Country:US
Mailing Address - Phone:715-848-3031
Mailing Address - Fax:715-848-5008
Practice Address - Street 1:614 N 3RD AVE
Practice Address - Street 2:SUITE A
Practice Address - City:WAUSAU
Practice Address - State:WI
Practice Address - Zip Code:54401-2913
Practice Address - Country:US
Practice Address - Phone:715-848-3031
Practice Address - Fax:715-848-5008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2503103TP2701X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI42126700Medicaid
WI42126700Medicaid