Provider Demographics
NPI:1720387855
Name:WABASH COUNTY HEALTH DEPARTMENT
Entity Type:Organization
Organization Name:WABASH COUNTY HEALTH DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF BEHAVIORAL HEALTH
Authorized Official - Prefix:
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:L
Authorized Official - Last Name:WISSEL
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LCPC
Authorized Official - Phone:618-263-4970
Mailing Address - Street 1:1001 N MARKET ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MOUNT CARMEL
Mailing Address - State:IL
Mailing Address - Zip Code:62863-1945
Mailing Address - Country:US
Mailing Address - Phone:618-263-4970
Mailing Address - Fax:
Practice Address - Street 1:130 W 7TH ST
Practice Address - Street 2:
Practice Address - City:MOUNT CARMEL
Practice Address - State:IL
Practice Address - Zip Code:62863-1439
Practice Address - Country:US
Practice Address - Phone:618-263-3873
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-15
Last Update Date:2011-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health