Organization Name: | BLUE WATERS FAMILY COUNSELING, S.C. |
NPI Number: | 1366556359 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DIANE M BERRY (DIRECTOR) |
Mailing Address: | 2215 Washington St Manitowoc |
State: | WI US |
Postal Code: | 542204847 |
Phone Number: | 9206833911 |
Fax Number: | 9206833411 |
NPI Enumeration Date: | 08/18/2006 |
NPI Last Update Date: | 02/08/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |