Provider Demographics
NPI:1588370308
Name:ENGAGE COUNSELING AND CONSULTATION LLC
Entity type:Organization
Organization Name:ENGAGE COUNSELING AND CONSULTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:HART
Authorized Official - Middle Name:
Authorized Official - Last Name:MEYRICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-340-9039
Mailing Address - Street 1:N7868 LAKESHORE LN
Mailing Address - Street 2:
Mailing Address - City:SHERWOOD
Mailing Address - State:WI
Mailing Address - Zip Code:54169-9633
Mailing Address - Country:US
Mailing Address - Phone:925-639-3666
Mailing Address - Fax:
Practice Address - Street 1:3701 E EVERGREEN DR STE 240
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54913-7409
Practice Address - Country:US
Practice Address - Phone:925-639-3666
Practice Address - Fax:800-813-9164
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-25
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty