Mr Randall John Ambrosius, MSW CADCIII LCSW | |
2611 12th St S, Mental Health Aoda Clinic, Wisconsin Rapids, WI 54494 | |
(715) 421-8849 | |
(715) 421-2266 |
Full Name | Mr Randall John Ambrosius |
---|---|
Gender | Male |
Speciality | Clinical Social Worker |
Experience | 32 Years |
Location | 2611 12th St S, Wisconsin Rapids, Wisconsin |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1487720769 | NPI | - | NPPES |
39354800 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YA0400X | Counselor - Addiction (substance Use Disorder) | 1834 (Wisconsin) | Primary |
1041C0700X | Social Worker - Clinical | 4186123 (Wisconsin) | Secondary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
La Clinica De Los Campesinos, Inc | 8729996574 | 16 |
Entity Name | La Clinica De Los Campesinos, Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1790786929 PECOS PAC ID: 8729996574 Enrollment ID: O20040806000058 |
Entity Name | Aspirus Stevens Point Hospital & Clinics, Inc. |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1538112230 PECOS PAC ID: 1850358938 Enrollment ID: O20041210000558 |
Mailing Address | Practice Location Address |
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Mr Randall John Ambrosius, MSW CADCIII LCSW 2611 12th St S, Wisconsin Rapids, WI 54494 Ph: (715) 421-8849 | Mr Randall John Ambrosius, MSW CADCIII LCSW 2611 12th St S, Mental Health Aoda Clinic, Wisconsin Rapids, WI 54494 Ph: (715) 421-8849 |
Louanne Pufall, CSAC Counselor Medicare: Not Enrolled in Medicare Practice Location: 2611 12th St S, Wisconsin Rapids, WI 54494 Phone: 715-421-8844 Fax: 715-421-2266 | |
Thomas Michael Surendonk, MSSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 420 1st Ave S, Wisconsin Rapids, WI 54495 Phone: 715-424-3400 Fax: 715-424-3441 | |
Karalee Flinders, Counselor Medicare: Not Enrolled in Medicare Practice Location: 420 3rd St S, Wisconsin Rapids, WI 54494 Phone: 715-712-1370 | |
Ms. Sandra Holmes, MS, CSAC, LPC Counselor Medicare: Medicare Enrolled Practice Location: 420 Dewey St, Wisconsin Rapids, WI 54494 Phone: 715-847-2772 | |
Ms. Constance K Virnig, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 420 1st Ave S, Po 1535, Wisconsin Rapids, WI 54495 Phone: 715-424-3400 Fax: 715-424-3441 | |
Mrs. Janelle Kathleen Hafermann, LPC, CSAC, ICS Counselor Medicare: Medicare Enrolled Practice Location: 320 W Grand Ave Ste 204, Wisconsin Rapids, WI 54495 Phone: 715-421-1107 Fax: 715-421-1108 | |
Tracy Renderman, SAC, IDP Counselor Medicare: Not Enrolled in Medicare Practice Location: 2611 12th St S, Wisconsin Rapids, WI 54494 Phone: 715-421-8869 |