| Beverly J Wilson, LPC | |
|
113 S Franklin St, Janesville, WI 53548-3812 | |
| (608) 756-5555 | |
| Not Available |
| Full Name | Beverly J Wilson |
|---|---|
| Gender | Female |
| Speciality | Counselor - Professional |
| Location | 113 S Franklin St, Janesville, Wisconsin |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528112448 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 660 (Wisconsin) | Primary |
| 101YP2500X | Counselor - Professional | 3615 (Wisconsin) | Primary |
| Entity Name | Mercy Health System Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1598718603 PECOS PAC ID: 7416860440 Enrollment ID: O20031113000164 |
| Mailing Address | Practice Location Address |
|---|---|
| Beverly J Wilson, LPC 113 S Franklin St, Janesville, WI 53548-3812 Ph: (608) 756-5555 | Beverly J Wilson, LPC 113 S Franklin St, Janesville, WI 53548-3812 Ph: (608) 756-5555 |
Michael G Braun, SAC-IT Counselor Medicare: Not Enrolled in Medicare Practice Location: 203 W Sunny Ln, Janesville, WI 53546 Phone: 608-741-4500 Fax: 608-741-4502 | |
Kamela D. Cisneros, Counselor Medicare: Medicare Enrolled Practice Location: 903 Mineral Point Ave, Janesville, WI 53548 Phone: 608-756-5555 Fax: 608-756-0174 | |
Carol Ann Ward, LPC,NCC Counselor Medicare: Medicare Enrolled Practice Location: 1519 Primrose Ln, Janesville, WI 53545 Phone: 608-752-7255 Fax: 608-752-6942 | |
Ms. Christina Renee Mcginn, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 203 W Sunny Ln, Janesville, WI 53546 Phone: 608-847-7575 | |
Tamra J Oman, CFT 14379130 Counselor Medicare: Not Enrolled in Medicare Practice Location: 203 W Sunny Lane, Janesville, WI 53546 Phone: 608-741-4500 Fax: 608-741-4516 | |
Jayme St. John, Counselor Medicare: Not Enrolled in Medicare Practice Location: 113 S Franklin St, Janesville, WI 53548 Phone: 608-757-5625 | |
Rebecca L Davis, LPC-IT, SAC Counselor Medicare: Medicare Enrolled Practice Location: 903 Mineral Point Ave, Janesville, WI 53548 Phone: 608-756-6530 Fax: 608-756-6564 |