| Family Services Of Southern Wisconsin And Northern Illinois | |
|
423 Bluff St Beloit WI 53511-6115 | |
| (608) 365-1244 | |
| (608) 365-4097 |
| Full Name | Family Services Of Southern Wisconsin And Northern Illinois |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 423 Bluff St, Beloit, Wisconsin |
| Authorized Official Name and Position | Jennifer L. Fruin (MENTAL HEALTH THERAPIST) |
| Authorized Official Contact | 6083651244 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Services Of Southern Wisconsin And Northern Illinois 423 Bluff St Beloit WI 53511-6115 Ph: (608) 365-1244 | Family Services Of Southern Wisconsin And Northern Illinois 423 Bluff St Beloit WI 53511-6115 Ph: (608) 365-1244 |
| NPI Number | 1093869505 |
|---|---|
| Provider Enumeration Date | 01/22/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093869505 | NPI | - | NPPES |
| 42117900 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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