Provider Demographics
NPI:1104670918
Name:ENSO COUNSELING LLC
Entity type:Organization
Organization Name:ENSO COUNSELING LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELISSA
Authorized Official - Middle Name:LEONORA
Authorized Official - Last Name:STULTS
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:715-201-2758
Mailing Address - Street 1:604 E LAKE ST
Mailing Address - Street 2:
Mailing Address - City:WAUPACA
Mailing Address - State:WI
Mailing Address - Zip Code:54981-1849
Mailing Address - Country:US
Mailing Address - Phone:608-228-9552
Mailing Address - Fax:715-204-7151
Practice Address - Street 1:750 BOWLING LN
Practice Address - Street 2:
Practice Address - City:WAUPACA
Practice Address - State:WI
Practice Address - Zip Code:54981-7707
Practice Address - Country:US
Practice Address - Phone:715-201-2758
Practice Address - Fax:715-204-7151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-16
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty