Provider Demographics
NPI:1578617320
Name:WETZEL-RASMUSSEN COUNSELING SERVICES
Entity Type:Organization
Organization Name:WETZEL-RASMUSSEN COUNSELING SERVICES
Other - Org Name:WETZEL RASMUSSEN COUNSELING SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER LICENSED PROFESSIONAL COUNSEL
Authorized Official - Prefix:MRS
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:WETZEL RASMUSSEN
Authorized Official - Suffix:
Authorized Official - Credentials:MA LPC
Authorized Official - Phone:715-275-3934
Mailing Address - Street 1:W10610 CLINIC STREET
Mailing Address - Street 2:PO BOX 278
Mailing Address - City:ELCHO
Mailing Address - State:WI
Mailing Address - Zip Code:54428-0278
Mailing Address - Country:US
Mailing Address - Phone:715-275-3934
Mailing Address - Fax:715-275-4510
Practice Address - Street 1:W10610 CLINIC ST.
Practice Address - Street 2:
Practice Address - City:ELCHO
Practice Address - State:WI
Practice Address - Zip Code:54428-0278
Practice Address - Country:US
Practice Address - Phone:715-275-3934
Practice Address - Fax:715-275-4533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3361125101YM0800X
WI352550202084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI42237000Medicaid
WI42237000Medicaid