Northwest Counseling & Guidance Clinic

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

License

2254 Issued in WI

Legal business name

NORTHWEST COUNSELING & GUIDANCE CLINIC

Practice address

203 United Way Drive
Frederic, WI 54837-8938

Phone

(715) 327-4402

Fax

(715) 327-4470

NPI assigned

Nov 18, 2006

Last updated

Mar 27, 2012By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jackie J Maurer

Title

Business Office Supervisor

Phone

(715) 327-4322

Specialties & licenses 1

Addresses

Other identifiers 4

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Diane Lynn Olson, MS

  • Mental Health Counselor
  • Amery, WI
  • NPI 1841599750
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332806400000",
    "number": "1104990530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 UNITED WAY DRIVE",
            "city": "FREDERIC",
            "state": "WI",
            "postal_code": "548378938",
            "telephone_number": "715-327-4322",
            "fax_number": "715-327-8509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 UNITED WAY DRIVE",
            "city": "FREDERIC",
            "state": "WI",
            "postal_code": "548378938",
            "telephone_number": "715-327-4402",
            "fax_number": "715-327-4470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST COUNSELING & GUIDANCE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-18",
        "last_updated": "2012-03-27",
        "status": "A",
        "authorized_official_last_name": "MAURER",
        "authorized_official_first_name": "JACKIE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "BUSINESS OFFICE SUPERVISOR",
        "authorized_official_telephone_number": "715-327-4322"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "WI",
            "license": "2254",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42214000",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "42626",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MN",
            "identifier": "7H956NO",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "85575",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joseph L Marek, DC
• Greg William McCormack, M.D.
• Tara L Mitchell, LPC
• Timothy D Newlin, LPC
• Caitlin Kehoe Nimm, PTA
• Northwest Passage LTD
• Jennifer Olson
• Kandis Joy Olson, OTR
• Orion Frederic LLC (Frederic Nursing and Rehabilitation Community)
• Pharmacy Operations Inc (Medicine Shoppe)

• Mental Health Clinic/Center (Including Community Mental Health Center) in Frederic, WI
• Providers in Frederic, WI by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.