Marjorie Y Mendoza, LPC | |
1205 S 70th St Ste 301, West Allis, WI 53214-3171 | |
(414) 485-6302 | |
Not Available |
Full Name | Marjorie Y Mendoza |
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Gender | Female |
Speciality | Counselor - Professional |
Location | 1205 S 70th St Ste 301, West Allis, Wisconsin |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1124324090 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | 7114-125 (Wisconsin) | Primary |
101YA0400X | Counselor - Addiction (substance Use Disorder) | 15574-132 (Wisconsin) | Secondary |
Entity Name | Professional Services Group Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1619024262 PECOS PAC ID: 8224296454 Enrollment ID: O20120220000742 |
Mailing Address | Practice Location Address |
---|---|
Marjorie Y Mendoza, LPC 8321 S 100th St, Franklin, WI 53132-2409 Ph: (414) 719-0076 | Marjorie Y Mendoza, LPC 1205 S 70th St Ste 301, West Allis, WI 53214-3171 Ph: (414) 485-6302 |
Nicholas Paul Hayon, Counselor Medicare: Not Enrolled in Medicare Practice Location: 10201 W Lincoln Ave, Suite 102, West Allis, WI 53227 Phone: 414-546-6880 Fax: 414-546-6891 | |
Lashawna Thomas, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2814 S 108th St, West Allis, WI 53227 Phone: 414-885-3525 Fax: 262-643-4617 | |
Ashley A Mitchell, SAC-IT Counselor Medicare: Not Enrolled in Medicare Practice Location: 2814 S 108th St, West Allis, WI 53227 Phone: 414-885-3525 | |
Charity Walsh, LPC-IT Counselor Medicare: Not Enrolled in Medicare Practice Location: 1205 S 70th St, Ste 301, West Allis, WI 53214 Phone: 414-475-2788 | |
Mr. Christian Lamarr Lemmie, LPC, SAC-IT Counselor Medicare: Not Enrolled in Medicare Practice Location: 2424 S 102nd St, West Allis, WI 53227 Phone: 414-203-4514 | |
Nicole F Jensen, LPC Counselor Medicare: Medicare Enrolled Practice Location: 2424 S 90th St, West Allis, WI 53227 Phone: 414-773-4312 Fax: 414-329-5637 | |
Grace Ellul, Counselor Medicare: Not Enrolled in Medicare Practice Location: 10150 W National Ave Ste 390, West Allis, WI 53227 Phone: 414-545-4430 |