NPIMap

Organization Active NPI

Northwest Counseling & Guidance Clinic

Doing business as Northwest Journey-Green Bay

  • Adolescent and Children Mental Health Clinic/Center
  • Green Bay, WI
National Provider Identifier
1295224657
Registry record updated May 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
License
3197 Issued in WI
Legal business name
NORTHWEST COUNSELING & GUIDANCE CLINIC
Doing business as
Northwest Journey-Green Bay
Practice address
123 S Van Buren
Green Bay, WI 54301-4441
Phone
(920) 336-8960
NPI assigned
May 1, 2018
Last updated
May 1, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2018

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

Authorized official

Name
Jackie Maurer
Title
Office Supervisor
Phone
(715) 349-7069

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent and Children Mental Health Clinic/Center 261QM0855X 3197 WI Primary

Addresses

Primary practice location

123 S Van Buren
Green Bay, WI 54301-4441

Mailing address

PO Box 309
Siren, WI 54872-0309
Phone (715) 349-5801

Other names 1

  • Northwest Journey-Green Bay Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Northwest Counseling Center22 organizations share this tax ID, including this one

Other organizations with this tax ID 21

Organizations that report the same tax identification number in the National Provider Directory.

View all 21

Locations

123 S Van Buren St
Green Bay, WI 54301
Phone (920) 336-8960

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1525132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525132800000",
    "number": "1295224657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 309",
            "city": "SIREN",
            "state": "WI",
            "postal_code": "548720309",
            "telephone_number": "715-349-5801",
            "fax_number": "888-625-8634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 S VAN BUREN",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543014441",
            "telephone_number": "920-336-8960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST COUNSELING & GUIDANCE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-01",
        "last_updated": "2018-05-01",
        "status": "A",
        "authorized_official_last_name": "MAURER",
        "authorized_official_first_name": "JACKIE",
        "authorized_official_title_or_position": "OFFICE SUPERVISOR",
        "authorized_official_telephone_number": "715-349-7069"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "WI",
            "license": "3197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northwest Journey-Green Bay",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Green Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2018; 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.