person
Shelly Lynn Dutch, CSAC,ICS
Addiction (Substance Use Disorder) Counselor in Madison, Wisconsin
NPI 1669678512

Shelly Lynn Dutch is an Addiction (Substance Use Disorder) Counselor based in Madison, WI and is specialized in Addiction (Substance Use Disorder). Shelly Lynn Dutch practices in Madison, WI and has the professional credentials of CSAC,ICS. The NPI Number for Shelly Lynn Dutch is 1669678512 and holds a License No. 1047-132 (Wisconsin).

The current practice location address for Shelly Lynn Dutch is 1334 Applegate Rd, Madison, WI and can be reached out via phone at 608-221-1500 and via fax at 608-221-1515. You can also correspond with Shelly Lynn Dutch through the mailing address at 1334 APPLEGATE RD, MADISON, WI - 53713-3184 (mailing address contact number: 608-221-1500).

Location: 1334 Applegate Rd, Madison, WI, 53713-3184
person
Provider Profile Details
NPI Number
1669678512
Provider Name
Shelly Lynn Dutch
Credential
CSAC,ICS
Provider Entity Type
Individual
Gender
Female
Address
1334 Applegate Rd, Madison, WI, 53713-3184
Phone Number
608-221-1500
Fax Number
608-221-1515
Provider Enumeration Date
06/26/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1047-132 01 WI CLINICAL SUB. ABUSE COUN
12230-134 01 WI INTERMEDIATE CLINICAL SUP
institution
Provider Business Practice Location Address Details
Address
1334 Applegate Rd
City
State
Zip
53713-3184
Phone Number
608-221-1500
Fax Number
608-221-1515
person
Provider Business Mailing Address Details
Address
1334 Applegate Rd
City
State
Zip
53713-3184
Phone Number
608-221-1500
Fax Number
608-221-1515
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
1047-132 (Wisconsin)
Definition
Definition to come...
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