Mark A Stahl, MSE, CADC, LPC | |
214 East Summer Street, Appleton, WI 54911 | |
(920) 734-2601 | |
(920) 727-1081 |
Full Name | Mark A Stahl |
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Gender | Male |
Speciality | Counselor - Professional |
Location | 214 East Summer Street, Appleton, Wisconsin |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1760567184 | NPI | - | NPPES |
43566400 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | 2967-125 (Wisconsin) | Primary |
Entity Name | Thedacare, Incorporated |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1376656959 PECOS PAC ID: 1759294887 Enrollment ID: O20031106000088 |
Mailing Address | Practice Location Address |
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Mark A Stahl, MSE, CADC, LPC 924 Tayco Street, Menasha, WI 54952 Ph: () - | Mark A Stahl, MSE, CADC, LPC 214 East Summer Street, Appleton, WI 54911 Ph: (920) 734-2601 |
Ms. Maria Gloria Vercimak, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 444 N Westhill Blvd, Appleton, WI 54914 Phone: 920-750-7000 Fax: 920-364-2451 | |
Pablo E Serna, Counselor Medicare: Not Enrolled in Medicare Practice Location: 410 S Walnut St, Appleton, WI 54911 Phone: 920-832-4741 Fax: 920-832-2185 | |
Kimberly Anne Johnson, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 3003 N Richmond St, Appleton, WI 54911 Phone: 920-730-1321 Fax: 920-734-2824 | |
Teri G Metropulos, LAPC Counselor Medicare: Medicare Enrolled Practice Location: 229 S. Morrison, Appleton, WI 54911 Phone: 920-832-2783 Fax: 920-832-2635 | |
Nhia Moua, APSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 5601 W Grande Market Dr Ste N, Appleton, WI 54913 Phone: 920-903-1060 Fax: 920-903-1164 | |
Trevor Konetzke, SAC-IT Counselor Medicare: Not Enrolled in Medicare Practice Location: 201 S Glenridge Ct, Appleton, WI 54914 Phone: 920-731-3981 | |
Mrs. Danielle Faye Falesnik, M.S. Counselor Medicare: Not Enrolled in Medicare Practice Location: 601 1/2 W College Ave Ste 3, Appleton, WI 54911 Phone: 920-795-7188 Fax: 920-570-6994 |