Provider Demographics
NPI:1356776769
Name:JOSEPH, TODD WILCHER (LPC, CSAC)
Entity type:Individual
Prefix:
First Name:TODD
Middle Name:WILCHER
Last Name:JOSEPH
Suffix:
Gender:M
Credentials:LPC, CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1905 S CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:MARSHFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:54449-4917
Mailing Address - Country:US
Mailing Address - Phone:715-898-1665
Mailing Address - Fax:715-898-1240
Practice Address - Street 1:1905 S CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:MARSHFIELD
Practice Address - State:WI
Practice Address - Zip Code:54449-4917
Practice Address - Country:US
Practice Address - Phone:715-898-1665
Practice Address - Fax:715-898-1240
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-05
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI8062-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL4838610OtherCERTIFIED PSYCHIATRIC REHABILITATION PRACTITIONER (CPRP)