Provider Demographics
NPI:1730273616
Name:FAMILY COUNSELING SERVICE OF WAUSAU INC.
Entity type:Organization
Organization Name:FAMILY COUNSELING SERVICE OF WAUSAU INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:COLLEEN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:RINKEN
Authorized Official - Suffix:
Authorized Official - Credentials:MED,LPC,CADCIII,CC
Authorized Official - Phone:715-842-3346
Mailing Address - Street 1:903 2ND ST
Mailing Address - Street 2:
Mailing Address - City:WAUSAU
Mailing Address - State:WI
Mailing Address - Zip Code:54403-4705
Mailing Address - Country:US
Mailing Address - Phone:715-842-3346
Mailing Address - Fax:715-842-3344
Practice Address - Street 1:903 2ND ST
Practice Address - Street 2:
Practice Address - City:WAUSAU
Practice Address - State:WI
Practice Address - Zip Code:54403-4705
Practice Address - Country:US
Practice Address - Phone:715-842-3346
Practice Address - Fax:715-842-3344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2008-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1321101YA0400X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI42110500Medicaid
WI42110500Medicaid