EXODUS COUNSELING CENTER, INC.


Address: 5800 North Bayshore Drive, Suite B 204, Glendale, WI 53217
Phone: 4149644357

EXODUS COUNSELING CENTER, INC. (NPI# 1871713628) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1871713628
Entity Type Organization
Organization Name EXODUS COUNSELING CENTER, INC.
Practice Address 5800 North Bayshore Drive
Suite B 204
Glendale
WI 53217
Mailing Address 5800 North Bayshore Dr
Suite B 204
Glendale
WI 53217
Practice Telephone 4149644357
Practice Fax Number 4149644327
Mailing Telephone 4149644357
Mailing Fax Number 4149644327
Enumeration Date 2007-04-26
Last Update Date 2020-08-22
Authorized Official Name DR. SCOTT STONER (EXECUTIVE DIRECTOR)
Authorized Official Telephone 4149644357
Authorized Official Credential D.MIN.
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 101YM0800X Counselor
Specialization: Mental Health
STATE MANDATED WI Behavioral Health & Social Service Providers

Office Location

Street Address 5800 NORTH BAYSHORE DRIVE
SUITE B 204
City GLENDALE
State WI
Zip Code 53217

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Taxonomy Information

Taxonomy Code 101YM0800X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization Mental Health

Taxonomy Definition

Definition to come...

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Competitor

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City GLENDALE
Zip Code 53217

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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