Ms Tonya Jean Gorst, MS | |
3900 W Brown Deer Rd, Suite 200, Brown Deer, WI 53209 | |
(414) 540-2170 | |
(414) 540-2171 |
Full Name | Ms Tonya Jean Gorst |
---|---|
Gender | Female |
Speciality | Counselor - Professional |
Location | 3900 W Brown Deer Rd, Brown Deer, Wisconsin |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1477613479 | NPI | - | NPPES |
43705600 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101Y00000X | Counselor | (* (Not Available)) | Secondary |
101YP2500X | Counselor - Professional | 4023-125 (Wisconsin) | Primary |
Entity Name | Shorehaven Behavioral Health Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1598800740 PECOS PAC ID: 0143324954 Enrollment ID: O20070404000380 |
Mailing Address | Practice Location Address |
---|---|
Ms Tonya Jean Gorst, MS 3900 W Brown Deer Rd, Suite 200, Brown Deer, WI 53209 Ph: (414) 540-2170 | Ms Tonya Jean Gorst, MS 3900 W Brown Deer Rd, Suite 200, Brown Deer, WI 53209 Ph: (414) 540-2170 |
Zoe Faivre Werth, M.S. Counselor Medicare: Not Enrolled in Medicare Practice Location: 3900 W Brown Deer Rd, Suite 200, Brown Deer, WI 53209 Phone: 414-540-2170 Fax: 414-540-2171 | |
Virginia G Livingston, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 7646 N Teutonia Ave, Brown Deer, WI 53209 Phone: 414-979-2155 | |
Jenna Mohelnitzky, LCSW Counselor Medicare: Medicare Enrolled Practice Location: 3900 W Brown Deer Rd Ste 200, Brown Deer, WI 53209 Phone: 414-540-2170 | |
Ms. Wendy Ann Diehls, APSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 3900 W Brown Deer Rd, Suite 200, Brown Deer, WI 53209 Phone: 414-540-2170 Fax: 414-540-2171 | |
Ms. Kristin Ann Johnson, MS LPC Counselor Medicare: Medicare Enrolled Practice Location: 3900 W Brown Deer Rd, Suite 200, Brown Deer, WI 53209 Phone: 414-540-2170 Fax: 414-540-2171 | |
Ramona Lewis, CADC III Counselor Medicare: Not Enrolled in Medicare Practice Location: 8200 W Brown Deer Rd, Suite 300a, Brown Deer, WI 53223 Phone: 414-362-8147 Fax: 414-362-7198 | |
Mrs. Kewonia Hogans-rhodes, MS, CRC, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 5050 W Brown Deer Rd Ste 200, Brown Deer, WI 53223 Phone: 414-368-0648 |