Provider Demographics
NPI:1326289224
Name:TOWLE, MARIA JEAN GOLDEN (MSW)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:JEAN GOLDEN
Last Name:TOWLE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:
Other - Last Name:GOLDEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:571 BRAUND ST
Mailing Address - Street 2:
Mailing Address - City:ONALASKA
Mailing Address - State:WI
Mailing Address - Zip Code:54650-8556
Mailing Address - Country:US
Mailing Address - Phone:608-785-7000
Mailing Address - Fax:
Practice Address - Street 1:571 BRAUND ST
Practice Address - Street 2:
Practice Address - City:ONALASKA
Practice Address - State:WI
Practice Address - Zip Code:54650-8556
Practice Address - Country:US
Practice Address - Phone:608-785-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-23
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI18559-130101YA0400X
WI9556-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100077198Medicaid