Provider Demographics
NPI:1336324433
Name:VISIONS COUNSELING INC
Entity type:Organization
Organization Name:VISIONS COUNSELING INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:AGENT COUNSELOR
Authorized Official - Prefix:MS
Authorized Official - First Name:GWENDOLYN
Authorized Official - Middle Name:JAYNE
Authorized Official - Last Name:MARTELL
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:715-551-1970
Mailing Address - Street 1:N2355 SMITH ROAD
Mailing Address - Street 2:
Mailing Address - City:MERRILL
Mailing Address - State:WI
Mailing Address - Zip Code:54452-9453
Mailing Address - Country:US
Mailing Address - Phone:715-539-3580
Mailing Address - Fax:
Practice Address - Street 1:N2355 SMITH ROAD
Practice Address - Street 2:
Practice Address - City:MERRILL
Practice Address - State:WI
Practice Address - Zip Code:54452-9453
Practice Address - Country:US
Practice Address - Phone:715-539-3580
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-08
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI42248500Medicaid