Provider Demographics
NPI:1194545392
Name:CONNECTION THERAPY & WELLNESS, LLC
Entity type:Organization
Organization Name:CONNECTION THERAPY & WELLNESS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:D
Authorized Official - Last Name:MICHAUD
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:715-861-3398
Mailing Address - Street 1:925 W RIVER ST STE 7
Mailing Address - Street 2:
Mailing Address - City:CHIPPEWA FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:54729-2188
Mailing Address - Country:US
Mailing Address - Phone:715-861-3398
Mailing Address - Fax:715-598-6250
Practice Address - Street 1:925 W RIVER ST STE 7
Practice Address - Street 2:
Practice Address - City:CHIPPEWA FALLS
Practice Address - State:WI
Practice Address - Zip Code:54729-2188
Practice Address - Country:US
Practice Address - Phone:715-861-3398
Practice Address - Fax:715-598-6250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-12
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)