Kathryn Lynn Mazack, | |
700 Ray O Vac Dr Ste 220, Madison, WI 53711-2476 | |
(608) 276-9191 | |
(608) 276-9144 |
Full Name | Kathryn Lynn Mazack |
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Gender | Female |
Speciality | Counselor - Professional |
Location | 700 Ray O Vac Dr Ste 220, Madison, Wisconsin |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1194497313 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | 5923-125 (Wisconsin) | Primary |
Entity Name | Family Therapy Center Of Madison, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1164587150 PECOS PAC ID: 1850285826 Enrollment ID: O20040211000028 |
Mailing Address | Practice Location Address |
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Kathryn Lynn Mazack, 524 Troy Dr, Madison, WI 53704-1575 Ph: (608) 445-3339 | Kathryn Lynn Mazack, 700 Ray O Vac Dr Ste 220, Madison, WI 53711-2476 Ph: (608) 276-9191 |
Maureen T Marshall, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 6510 Grand Teton Plaza, Ste 406, Madison, WI 53719 Phone: 608-833-9290 Fax: 608-833-9290 | |
Jessica Marie Gutierrez, LCSW, CSAC, ICS Counselor Medicare: Medicare Enrolled Practice Location: 2101 Linden Ave Apt 2, Madison, WI 53704 Phone: 608-466-6560 | |
Amanda Henn, Counselor Medicare: Not Enrolled in Medicare Practice Location: 625 W Washington Ave, Madison, WI 53703 Phone: 608-280-2700 | |
Lance P Armstrong, CSAC Counselor Medicare: Not Enrolled in Medicare Practice Location: 25 Kessel Ct, Ste 200, Madison, WI 53711 Phone: 608-278-8200 Fax: 608-278-8204 | |
Ms. Katherine Mary Delchambre, Counselor Medicare: Not Enrolled in Medicare Practice Location: 5310 Wall Street, Ste. 500, Madison, WI 53718 Phone: 608-274-8294 Fax: 608-274-8783 | |
Michael Walmer, M.S., LPC-T/SUD, NCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 625 W Washington Ave, Madison, WI 53703 Phone: 608-280-2700 | |
Christina Murphy, Counselor Medicare: Not Enrolled in Medicare Practice Location: 559 Zor Shrine Pl, Madison, WI 53719 Phone: 608-833-0123 |