Provider Demographics
NPI:1326713330
Name:SUMMIT COUNSELING LLC
Entity Type:Organization
Organization Name:SUMMIT COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOTHERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHAN
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:GUNN
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPC,NCC
Authorized Official - Phone:262-793-0991
Mailing Address - Street 1:2717 N GRANDVIEW BLVD STE 112
Mailing Address - Street 2:
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53188-1660
Mailing Address - Country:US
Mailing Address - Phone:262-793-0991
Mailing Address - Fax:
Practice Address - Street 1:2717 N GRANDVIEW BLVD STE 112
Practice Address - Street 2:
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53188-1660
Practice Address - Country:US
Practice Address - Phone:262-933-1071
Practice Address - Fax:888-867-0673
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-11
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health