Provider Demographics
NPI:1215500152
Name:HOME BODY COUNSELING, LCC
Entity type:Organization
Organization Name:HOME BODY COUNSELING, LCC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ZOE
Authorized Official - Middle Name:
Authorized Official - Last Name:WHALEY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:608-433-7323
Mailing Address - Street 1:S11251 FAIRVIEW RD
Mailing Address - Street 2:
Mailing Address - City:SPRING GREEN
Mailing Address - State:WI
Mailing Address - Zip Code:53588-9775
Mailing Address - Country:US
Mailing Address - Phone:608-469-4349
Mailing Address - Fax:
Practice Address - Street 1:E7995 SCHOOL RD
Practice Address - Street 2:
Practice Address - City:SAUK CITY
Practice Address - State:WI
Practice Address - Zip Code:53583-9637
Practice Address - Country:US
Practice Address - Phone:608-433-7323
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-19
Last Update Date:2021-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty