Provider Demographics
NPI:1902069776
Name:PEACE TREE COUNSELING LLC
Entity Type:Organization
Organization Name:PEACE TREE COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:ZELLMER
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:715-417-3241
Mailing Address - Street 1:PO BOX 817
Mailing Address - Street 2:
Mailing Address - City:OSCEOLA
Mailing Address - State:WI
Mailing Address - Zip Code:54020-0816
Mailing Address - Country:US
Mailing Address - Phone:715-755-2233
Mailing Address - Fax:715-755-3966
Practice Address - Street 1:108 CHIEFTAIN STREET
Practice Address - Street 2:SUITE B
Practice Address - City:OSCEOLA
Practice Address - State:WI
Practice Address - Zip Code:54020-0816
Practice Address - Country:US
Practice Address - Phone:715-417-3241
Practice Address - Fax:715-417-3243
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-02
Last Update Date:2020-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2792101YM0800X
261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty