Provider Demographics
NPI:1346702826
Name:KRIS HUENINK COUNSELING SERVICES LLC
Entity Type:Organization
Organization Name:KRIS HUENINK COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MED MANAGMENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:ELKIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:262-646-6280
Mailing Address - Street 1:501 N 8TH ST STE 110
Mailing Address - Street 2:
Mailing Address - City:SHEBOYGAN
Mailing Address - State:WI
Mailing Address - Zip Code:53081-4461
Mailing Address - Country:US
Mailing Address - Phone:920-838-1481
Mailing Address - Fax:
Practice Address - Street 1:501 N 8TH ST STE 110
Practice Address - Street 2:
Practice Address - City:SHEBOYGAN
Practice Address - State:WI
Practice Address - Zip Code:53081-4461
Practice Address - Country:US
Practice Address - Phone:920-838-1481
Practice Address - Fax:920-286-6233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-03
Last Update Date:2019-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health