Provider Demographics
NPI:1457619389
Name:ADVOCATE PSYCHOTHERAPY SERVICES LLC
Entity type:Organization
Organization Name:ADVOCATE PSYCHOTHERAPY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-544-4435
Mailing Address - Street 1:PO BOX 959
Mailing Address - Street 2:
Mailing Address - City:STEVENS POINT
Mailing Address - State:WI
Mailing Address - Zip Code:54481-0959
Mailing Address - Country:US
Mailing Address - Phone:715-544-4435
Mailing Address - Fax:800-681-2374
Practice Address - Street 1:3233A BUSINESS PARK DR STE 304
Practice Address - Street 2:
Practice Address - City:STEVENS POINT
Practice Address - State:WI
Practice Address - Zip Code:54482-8861
Practice Address - Country:US
Practice Address - Phone:715-544-4435
Practice Address - Fax:715-952-4995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-28
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health