| Anesis Center For Marriage And Family Therapy | |
|
815 Forward Dr. Madison WI 53711 | |
| (608) 268-6530 | |
| (608) 709-1744 |
| Full Name | Anesis Center For Marriage And Family Therapy |
|---|---|
| Speciality | Clinic/Center |
| Location | 815 Forward Dr., Madison, Wisconsin |
| Authorized Official Name and Position | Myra Mcnair (OWNER, SERVICE DIRECTOR) |
| Authorized Official Contact | 6082686530 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Anesis Center For Marriage And Family Therapy 815 Forward Dr. Madison WI 53711 Ph: (608) 268-6530 | Anesis Center For Marriage And Family Therapy 815 Forward Dr. Madison WI 53711 Ph: (608) 268-6530 |
| NPI Number | 1720586761 |
|---|---|
| Provider Enumeration Date | 01/24/2018 |
| Last Update Date | 12/20/2021 |
| Certification Date | 12/20/2021 |
| Medicare PECOS PAC ID | 8628491297 |
|---|---|
| Medicare Enrollment ID | O20200715001056 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720586761 | NPI | - | NPPES |
| Provider Name | Brittany R Neal |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609420579 PECOS PAC ID: 7618391202 Enrollment ID: I20200715001838 |
| Provider Name | Vanessa D Statam |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659926509 PECOS PAC ID: 8628492220 Enrollment ID: I20200715002149 |
| Provider Name | Kianna J Goodwin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942859616 PECOS PAC ID: 8224454582 Enrollment ID: I20200817003379 |
| Provider Name | Debie Evans |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871890756 PECOS PAC ID: 5294131470 Enrollment ID: I20210914001520 |
| Provider Name | Vilitha Clay |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174117774 PECOS PAC ID: 7416353503 Enrollment ID: I20210915002586 |
| Provider Name | Andrea Bonaparte |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558946285 PECOS PAC ID: 1759788862 Enrollment ID: I20210916000272 |
| Provider Name | Nicholas Ballweg |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982221933 PECOS PAC ID: 6507258118 Enrollment ID: I20220111001847 |
| Provider Name | Pazee Yang |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851626766 PECOS PAC ID: 3476911207 Enrollment ID: I20230626003138 |
| Provider Name | Fjolla Riza |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265039697 PECOS PAC ID: 2264830090 Enrollment ID: I20230705000065 |
| Provider Name | Myra Mcnair |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1114368933 PECOS PAC ID: 5496178089 Enrollment ID: I20240317000052 |
| Provider Name | Rhiannon Kunesh |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689355547 PECOS PAC ID: 1557708146 Enrollment ID: I20240319000551 |
| Provider Name | Serena Yu |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1619580636 PECOS PAC ID: 3577900109 Enrollment ID: I20240319001535 |
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