Oneida Nation

NPI #1205825130 in Green Bay, Wisconsin

Provider Information

NPI Number: 1205825130
Entity Type: Organization
Organization Name: Oneida Nation
Primary Specialty: Clinic/Center - Mental Health (Including Community Mental Health Center)
Enumeration Date: Oct 13, 2005
Last Updated: Dec 3, 2020

Practice Location

Address: 2640 W POINT RD
City: Green Bay
State: Wisconsin
ZIP Code: 54304-1344
Phone: (920) 490-3790

Authorized Official

Name: MARI KRIESCHER, MS LPC CSAC ICS
Title: BEHAVIORAL HEALTH MANAGER
Phone: (920) 490-3790

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Federally Qualified Health Center (FQHC) — Federally Qualified Health Center (FQHC)	261QF0400X
Clinic/Center - Mental Health (Including Community Mental Health Center) — Mental Health (Including Community Mental Health Center)	261QM0801X	Primary

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