Provider Demographics
NPI:1396934576
Name:OSWALD COUNSELING ASSOCIATES, INC.
Entity type:Organization
Organization Name:OSWALD COUNSELING ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:LYNNE
Authorized Official - Middle Name:T
Authorized Official - Last Name:OSWALD
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LCSW, CSAC
Authorized Official - Phone:715-342-0290
Mailing Address - Street 1:2450 VINEYARD DR
Mailing Address - Street 2:
Mailing Address - City:PLOVER
Mailing Address - State:WI
Mailing Address - Zip Code:54467-3973
Mailing Address - Country:US
Mailing Address - Phone:715-342-0290
Mailing Address - Fax:
Practice Address - Street 1:2450 VINEYARD DR
Practice Address - Street 2:
Practice Address - City:PLOVER
Practice Address - State:WI
Practice Address - Zip Code:54467-3973
Practice Address - Country:US
Practice Address - Phone:715-342-0290
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-23
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2566101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI42239200Medicaid