NPIMap

Organization Active NPI

Northwest Counseling & Guidance Clinic

Doing business as Northwest Journey - Northern Lights

  • Adolescent and Children Mental Health Clinic/Center
  • Superior, WI
National Provider Identifier
1790143667
Registry record updated Mar 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
Legal business name
NORTHWEST COUNSELING & GUIDANCE CLINIC
Doing business as
Northwest Journey - Northern Lights
Practice address
69 N 28TH St E
Superior, WI 54880-6525
Phone
(715) 718-2777
Fax
(715) 394-2869
NPI assigned
Feb 5, 2016
Last updated
Mar 21, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
NORTHWEST COUNSELING & GUIDANCE CLINICAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 21, 2024

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 WI Primary

Addresses

Primary practice location

69 N 28TH St E
Superior, WI 54880-6525

Mailing address

PO Box 309
Siren, WI 54872-0309
Phone (715) 349-7069

Other names 1

  • Northwest Journey - Northern Lights Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Northwest CNSL Guid22 organizations share this tax ID, including this one
Part of
Northwest CNSL Guid

Other organizations with this tax ID 21

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

View all 21

Locations

1201 N 28th St
Superior, WI 54880
Phone (715) 395-6066

69 N 28th St E
Superior, WI 54880
Phone (715) 392-4722

NPI Registry JSON

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

{
    "created_epoch": "1454630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710979200000",
    "number": "1790143667",
    "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": "715-349-7069",
            "fax_number": "715-327-8509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69 N 28TH ST E",
            "city": "SUPERIOR",
            "state": "WI",
            "postal_code": "548806525",
            "telephone_number": "715-718-2777",
            "fax_number": "715-394-2869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST COUNSELING & GUIDANCE CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTHWEST COUNSELING & GUIDANCE CLINIC",
        "enumeration_date": "2016-02-05",
        "last_updated": "2024-03-21",
        "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": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northwest Journey - Northern Lights",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Superior, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2024; 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.