Anthony Roach, PC-IT, SW | |
3900 W Brown Deer Rd, Ste 200, Brown Deer, WI 53209-1220 | |
(414) 540-2170 | |
(414) 540-2171 |
Full Name | Anthony Roach |
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Gender | Male |
Speciality | Counselor - Professional |
Location | 3900 W Brown Deer Rd, Brown Deer, Wisconsin |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1083968200 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | 1281-226 (Wisconsin) | Primary |
104100000X | Social Worker | 7196-120 (Wisconsin) | Secondary |
Entity Name | Shorehaven Behavioral Health Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1598800740 PECOS PAC ID: 0143324954 Enrollment ID: O20070404000380 |
Mailing Address | Practice Location Address |
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Anthony Roach, PC-IT, SW 3900 W Brown Deer Rd, Ste 200, Brown Deer, WI 53209-1220 Ph: (414) 540-2170 | Anthony Roach, PC-IT, SW 3900 W Brown Deer Rd, Ste 200, Brown Deer, WI 53209-1220 Ph: (414) 540-2170 |
Zoe Faivre Werth, M.S. Counselor Medicare: Not Enrolled in Medicare Practice Location: 3900 W Brown Deer Rd, Suite 200, Brown Deer, WI 53209 Phone: 414-540-2170 Fax: 414-540-2171 | |
Virginia G Livingston, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 7646 N Teutonia Ave, Brown Deer, WI 53209 Phone: 414-979-2155 | |
Jenna Mohelnitzky, LCSW Counselor Medicare: Medicare Enrolled Practice Location: 3900 W Brown Deer Rd Ste 200, Brown Deer, WI 53209 Phone: 414-540-2170 | |
Ms. Wendy Ann Diehls, APSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 3900 W Brown Deer Rd, Suite 200, Brown Deer, WI 53209 Phone: 414-540-2170 Fax: 414-540-2171 | |
Ms. Kristin Ann Johnson, MS LPC Counselor Medicare: Medicare Enrolled Practice Location: 3900 W Brown Deer Rd, Suite 200, Brown Deer, WI 53209 Phone: 414-540-2170 Fax: 414-540-2171 | |
Ramona Lewis, CADC III Counselor Medicare: Not Enrolled in Medicare Practice Location: 8200 W Brown Deer Rd, Suite 300a, Brown Deer, WI 53223 Phone: 414-362-8147 Fax: 414-362-7198 | |
Mrs. Kewonia Hogans-rhodes, MS, CRC, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 5050 W Brown Deer Rd Ste 200, Brown Deer, WI 53223 Phone: 414-368-0648 |