Thomas John Gozinske, LPC-IT

Individual provider Active NPI Professional Counselor · Muscoda, WI

NPI 1477058519 · NPPES record last updated Jul 31, 2023

Key facts

NPI
1477058519
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
10539-125 (WI)
Practice address
746 State Road 133
Muscoda, WI 53573-8850
Phone
(608) 604-4510
NPI assigned
Mar 29, 2018
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
10539-125WIMDProfessional Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 10539-125 WI Yes

Addresses

Primary practice location

746 State Road 133
Muscoda, WI 53573-8850

Mailing address

746 State Road 133
Muscoda, WI 53573-8850
Phone (608) 604-4510

Other practice location 1

23291 County Hwy AA
Richland Center, WI 53581-6305
Phone (608) 647-2222

Other providers in Muscoda, WI

All providers in Muscoda, WI · Professional Counselor in Wisconsin

Sources for this page

Verify at the official NPI Registry.