Provider Demographics
NPI:1841030814
Name:RECHEK PSYCHOTHERAPY SERVICES LLC
Entity type:Organization
Organization Name:RECHEK PSYCHOTHERAPY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:RECHEK
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:920-583-0760
Mailing Address - Street 1:924 ROCK AVE
Mailing Address - Street 2:
Mailing Address - City:WAUPUN
Mailing Address - State:WI
Mailing Address - Zip Code:53963-1218
Mailing Address - Country:US
Mailing Address - Phone:920-583-0760
Mailing Address - Fax:
Practice Address - Street 1:101 WISCONSIN AMERICAN DR STE 150
Practice Address - Street 2:
Practice Address - City:FOND DU LAC
Practice Address - State:WI
Practice Address - Zip Code:54937-6704
Practice Address - Country:US
Practice Address - Phone:920-583-0760
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-28
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty