Provider Demographics
NPI:1497347827
Name:SOLID GROUND COUNSELING LLC
Entity Type:Organization
Organization Name:SOLID GROUND COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CONNIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:MOHAWK
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:715-634-2575
Mailing Address - Street 1:PO BOX 6
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:WI
Mailing Address - Zip Code:54843-0006
Mailing Address - Country:US
Mailing Address - Phone:715-634-2575
Mailing Address - Fax:
Practice Address - Street 1:15792 W WOLF LN
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:WI
Practice Address - Zip Code:54843-6553
Practice Address - Country:US
Practice Address - Phone:715-634-2575
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-08
Last Update Date:2021-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health