| Theresa Ketchum-fish, | |
|
300 Main St W, Ashland, WI 54806-1639 | |
| (715) 685-2200 | |
| Not Available |
| Full Name | Theresa Ketchum-fish |
|---|---|
| Gender | Female |
| Speciality | Counselor - Professional |
| Location | 300 Main St W, Ashland, Wisconsin |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194126433 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 6395-125 (Wisconsin) | Primary |
| Entity Name | Bad River Band Of Lake Superior Tribe Of Chippewa Indians Wis |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1699701375 PECOS PAC ID: 7810089414 Enrollment ID: O20160330000840 |
| Mailing Address | Practice Location Address |
|---|---|
| Theresa Ketchum-fish, 7665 Us Highway 2, Iron River, WI 54847-4690 Ph: (715) 685-2200 | Theresa Ketchum-fish, 300 Main St W, Ashland, WI 54806-1639 Ph: (715) 685-2200 |
Roseanne Bitzer, MSE, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 301 Ellis Ave Ste 1, Ashland, WI 54806 Phone: 715-682-3523 Fax: 715-682-3526 | |
Lori Anne Decarlo-kienitz, CSAC Counselor Medicare: Not Enrolled in Medicare Practice Location: 502 Main St W Ste 305, Ashland, WI 54806 Phone: 715-682-5207 Fax: 715-682-5209 | |
Nicole Landucci, Counselor Medicare: Not Enrolled in Medicare Practice Location: 517 Beaser Ave, Ashland, WI 54806 Phone: 651-249-6533 | |
Russell John Denomie, Counselor Medicare: Not Enrolled in Medicare Practice Location: 53585 Nokomis Rd, Ashland, WI 54806 Phone: 715-682-7133 | |
Holly H Hagstrom, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 405 Lake Shore Dr E, Ashland, WI 54806 Phone: 715-682-3523 Fax: 715-682-3526 | |
Ms. Janet M Lewis, LPC, APSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 1635 Maple Ln, Ashland, WI 54806 Phone: 715-685-5400 Fax: 715-685-5102 | |
Ms. Hazel Margaret Reed Mcclaire, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1635 Maple Ln, Ashland, WI 54806 Phone: 715-685-5400 Fax: 715-685-5102 |