Provider Demographics
NPI:1740454610
Name:CATALYST FOR CHANGE CONSULTANTS
Entity type:Organization
Organization Name:CATALYST FOR CHANGE CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:JULEFF
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:608-685-4191
Mailing Address - Street 1:317 S 2ND ST
Mailing Address - Street 2:PO BOX 305
Mailing Address - City:ALMA
Mailing Address - State:WI
Mailing Address - Zip Code:54610-7700
Mailing Address - Country:US
Mailing Address - Phone:608-685-4191
Mailing Address - Fax:
Practice Address - Street 1:317 S 2ND ST
Practice Address - Street 2:
Practice Address - City:ALMA
Practice Address - State:WI
Practice Address - Zip Code:54610-7700
Practice Address - Country:US
Practice Address - Phone:608-685-4191
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-22
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI684-124251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI40975000Medicaid