Provider Demographics
NPI:1205377801
Name:AVENUES COUNSELING, LLC
Entity Type:Organization
Organization Name:AVENUES COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHILT
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:608-293-1155
Mailing Address - Street 1:1118 15TH AVE
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:WI
Mailing Address - Zip Code:53566-2042
Mailing Address - Country:US
Mailing Address - Phone:608-325-1070
Mailing Address - Fax:608-325-1070
Practice Address - Street 1:1118 15TH AVE
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:WI
Practice Address - Zip Code:53566-2042
Practice Address - Country:US
Practice Address - Phone:608-325-1070
Practice Address - Fax:608-325-1070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-15
Last Update Date:2017-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5855-125101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100033677Medicaid