Organization · Type 2 NPI

Integrated Counseling Center LLC

Clinical Social Worker · Fond Du Lac, WI

NPI number 1104053701 Active

Practice location

N6687 Wrightway Dr Ste D
Fond Du Lac, WI 54937-8433

Fax (920) 929-9142

Specialties and licenses

TaxonomyCodeLicense
Professional Counselor 101YP2500X29-036 (WI)
Clinical Psychologist 103TC0700X2270-057 (WI)
Clinical Social Worker Primary 1041C0700X7003-123 (WI)
Clinical Social Worker 1041C0700X7209-123 (WI)

Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…

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About NPI 1104053701

Integrated Counseling Center LLC's National Provider Identifier is 1104053701, issued on Jun 22, 2009. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Fond Du Lac, WI. The record was last updated on Jun 22, 2009.