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145 W Wisconsin Ave Neenah WI 54956-3075 | |
| (920) 725-1230 | |
| (920) 744-1449 |
| Full Name | |
|---|---|
| Speciality | Counselor |
| Location | 145 W Wisconsin Ave, Neenah, Wisconsin |
| Authorized Official Name and Position | Lisa K Anderson (OWNER) |
| Authorized Official Contact | 9207251230 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
145 W Wisconsin Ave Neenah WI 54956-3075 Ph: (920) 725-1230 | 145 W Wisconsin Ave Neenah WI 54956-3075 Ph: (920) 725-1230 |
| NPI Number | 1215401468 |
|---|---|
| Provider Enumeration Date | 01/21/2019 |
| Last Update Date | 01/13/2020 |
| Certification Date | 01/13/2020 |
| Medicare PECOS PAC ID | 8325489438 |
|---|---|
| Medicare Enrollment ID | O20240507002543 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215401468 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Kristen A Palmer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811500358 PECOS PAC ID: 7012322712 Enrollment ID: I20210210001298 |
| Provider Name | Kristen M Paschke |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1861002057 PECOS PAC ID: 9234581950 Enrollment ID: I20240307001212 |
| Provider Name | Lisa K Anderson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1982005880 PECOS PAC ID: 0143661256 Enrollment ID: I20240507002731 |
| Provider Name | Catherine A Mcconnell |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1013061761 PECOS PAC ID: 5991767543 Enrollment ID: I20240703003476 |
| Provider Name | Jolie R Heggeseth |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1942884267 PECOS PAC ID: 5890230791 Enrollment ID: I20240716002105 |
| Provider Name | Thomas J Wood |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1861015414 PECOS PAC ID: 3375081276 Enrollment ID: I20240809002005 |
| Provider Name | Lisa T Wood |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1295414423 PECOS PAC ID: 9436698024 Enrollment ID: I20240827003313 |
| Provider Name | Kadihjia S Kelly |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1821539933 PECOS PAC ID: 0143760512 Enrollment ID: I20240912000173 |
| Provider Name | Nancy Homb |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1427737055 PECOS PAC ID: 2860932175 Enrollment ID: I20240912001843 |
| Provider Name | Nicole Devalk |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1417518812 PECOS PAC ID: 4385185529 Enrollment ID: I20240916001958 |
| Provider Name | Jennifer Michener |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1669892238 PECOS PAC ID: 8820539075 Enrollment ID: I20240916002292 |
| Provider Name | Amy M Taake |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1194234922 PECOS PAC ID: 5193256113 Enrollment ID: I20241002000041 |
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