Sacred Wandering / Sacred Path Practitioners
Organization Active NPI Mental Health Clinic/Center (Including Community Mental Health Center) · Mequon, WI
NPI 1780240614 · NPPES record last updated May 16, 2019
Key facts
- NPI
- 1780240614
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
- Legal business name
- SACRED WANDERING / SACRED PATH PRACTITIONERS
- Practice address
- 10134 N Port Washington Rd Ste G
Mequon, WI 53092-5700 - Phone
- (414) 433-9193
- Fax
- (414) 435-9611
- NPI assigned
- May 16, 2019
- Organization subpart
- No
Authorized official
- Name
- Kenneth J Nelan, MS, LPC, NCC
- Title
- Owner/Provider
- Phone
- (414) 433-9193
Practitioners 1
National Provider Directory
Locations
10134 N Port Washington Rd
Ste G
Mequon, WI 53092
Phone (414) 433-9193
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | Yes |
Addresses
Primary practice location
10134 N Port Washington Rd Ste G
Mequon, WI 53092-5700
Mailing address
10134 N Port Washington Rd Ste G
Mequon, WI 53092-5700
Phone (414) 433-9193
Other providers in Mequon, WI
- Susan Ryack
- Cathy E. Ryan
- Stephan B. Ryan
- Mikaella Sabinash
- Sacred Heart Rehabilitation Institute, Inc.
- Giovanna Safina
- Leena Saifuddin
- Sonia P Salazar
- Sofia Salerno
- Lauren Elizabeth Tiehen Salit
All providers in Mequon, WI · Mental Health Clinic/Center (Including Community Mental Health Center) in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 16, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.