Provider Demographics
NPI:1760977086
Name:ATWELL, ELISABETH RUTH (MA, LPC, CSAC, ICS)
Entity type:Individual
Prefix:
First Name:ELISABETH
Middle Name:RUTH
Last Name:ATWELL
Suffix:
Gender:F
Credentials:MA, LPC, CSAC, ICS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 S 3RD ST
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53536-1256
Mailing Address - Country:US
Mailing Address - Phone:920-819-1712
Mailing Address - Fax:608-917-2001
Practice Address - Street 1:7 E MAIN ST STE 4
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:WI
Practice Address - Zip Code:53536-1370
Practice Address - Country:US
Practice Address - Phone:608-285-2424
Practice Address - Fax:608-917-2001
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-28
Last Update Date:2025-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6220-125101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty