Provider Demographics
NPI:1801420237
Name:WITHIN REACH LLC
Entity type:Organization
Organization Name:WITHIN REACH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCSW
Authorized Official - Prefix:
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:SUSSEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-423-6636
Mailing Address - Street 1:302 CENTER ST
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:WI
Mailing Address - Zip Code:53956-1326
Mailing Address - Country:US
Mailing Address - Phone:608-423-6636
Mailing Address - Fax:
Practice Address - Street 1:169 STARK ST
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:WI
Practice Address - Zip Code:53956-1298
Practice Address - Country:US
Practice Address - Phone:608-423-6636
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-25
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty