Provider Demographics
NPI:1932100864
Name:HAAG MENTAL HEALTH CONSULTING, INC.
Entity Type:Organization
Organization Name:HAAG MENTAL HEALTH CONSULTING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:VELMA
Authorized Official - Middle Name:
Authorized Official - Last Name:HAAG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-635-2146
Mailing Address - Street 1:415 N MAIN ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:POYNETTE
Mailing Address - State:WI
Mailing Address - Zip Code:53955-8963
Mailing Address - Country:US
Mailing Address - Phone:605-635-2146
Mailing Address - Fax:
Practice Address - Street 1:415 N MAIN ST
Practice Address - Street 2:SUITE 3
Practice Address - City:POYNETTE
Practice Address - State:WI
Practice Address - Zip Code:53955-8963
Practice Address - Country:US
Practice Address - Phone:605-635-2146
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-02
Last Update Date:2009-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2017-123101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI0001Medicaid
WV0004Medicaid
WV0004Medicaid