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Contact Information

LIVING WELL MENTAL HEALTH CLINIC LLC
112 N CENTRAL AVE
OWEN, WI54460
 Phone: 715-313-4748
 Fax: 715-229-0331
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

103TC0700X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for LIVING WELL MENTAL HEALTH CLINIC LLC · (Female)

NPI Number 1013413657
Status Active
Credentials
Entity Individual
Enumeration date 04/03/2018
Last updated 08/16/2024 - More than a year ago
Sole proprietor 1 Not specified
Identifiers
  • WI Medicaid 1184002560
  • WI Medicaid 1548793235
  • WI Medicaid 1720477182
  • WI Medicaid K400340967
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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