Maple Tree Wellness, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

8384-123 Issued in WI

Legal business name

MAPLE TREE WELLNESS, LLC

Practice address

205 5TH Ave S Ste 306
La Crosse, WI 54601-4059

Phone

(608) 466-6411

Fax

(608) 572-7737

NPI assigned

Sep 20, 2016

Organization subpart

No

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

Authorized official

Name

Ms. Lauren Gourley, LCSW

Title

Therapist

Phone

(608) 466-6411

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1474329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659916800000",
    "number": "1962950865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2920 EAST AVE S STE 101",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546018282",
            "telephone_number": "608-466-6411",
            "fax_number": "608-572-7737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 5TH AVE S STE 306",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546014059",
            "telephone_number": "608-466-6411",
            "fax_number": "608-572-7737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAPLE TREE WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-20",
        "last_updated": "2022-08-08",
        "certification_date": "2022-08-08",
        "status": "A",
        "authorized_official_last_name": "GOURLEY",
        "authorized_official_first_name": "LAUREN",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "608-466-6411",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "8384-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian R Manske, MD
• Steven R Manson, MD
• Kale Manuel, MD
• Ryan Michael Manz, MD
• Sarah Manzoor, MD
• Laura K Marchiando, MD
• Richard J Marchiando, DO
• Titia Jo Marcou, BSW
• Kristen Marie Marin, LP
• David Edward Marinier, M.D.

• Clinical Social Worker in La Crosse, WI
• Providers in La Crosse, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2022; 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.