Provider Demographics
NPI:1457320723
Name:DIX & GILLETTE COUNSELING SERVICES LLP
Entity Type:Organization
Organization Name:DIX & GILLETTE COUNSELING SERVICES LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER PSYCHOTHERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:PHILIP
Authorized Official - Last Name:DIX
Authorized Official - Suffix:
Authorized Official - Credentials:MSMFT CADC III
Authorized Official - Phone:715-675-3888
Mailing Address - Street 1:1720 MERRILL AVE
Mailing Address - Street 2:STE 401
Mailing Address - City:WAUSAU
Mailing Address - State:WI
Mailing Address - Zip Code:54401
Mailing Address - Country:US
Mailing Address - Phone:715-675-3888
Mailing Address - Fax:715-675-2988
Practice Address - Street 1:1720 MERRILL AVE
Practice Address - Street 2:STE 401
Practice Address - City:WAUSAU
Practice Address - State:WI
Practice Address - Zip Code:54401
Practice Address - Country:US
Practice Address - Phone:715-675-3888
Practice Address - Fax:715-675-2988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty