Children's Service Society Of Wisconsin | |
1716 Fordem Ave Madison WI 53704-4604 | |
(608) 221-3511 | |
(608) 221-3514 |
Full Name | Children's Service Society Of Wisconsin |
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Speciality | Social Worker - Clinical |
Location | 1716 Fordem Ave, Madison, Wisconsin |
Authorized Official Name and Position | Ron Pupp (DIRECTOR OF COUNSELING) |
Authorized Official Contact | 4142314808 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Children's Service Society Of Wisconsin 1716 Fordem Ave Madison WI 53704-4604 Ph: (608) 221-3511 | Children's Service Society Of Wisconsin 1716 Fordem Ave Madison WI 53704-4604 Ph: (608) 221-3511 |
NPI Number | 1528232386 |
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Provider Enumeration Date | 04/14/2008 |
Last Update Date | 11/23/2011 |
Identifier | Type | State | Issuer |
---|---|---|---|
1528232386 | NPI | - | NPPES |
42115300 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
106H00000X | Marriage & Family Therapist | (* (Not Available)) | Secondary |
Nrrc, Sc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 702 N Blackhawk Ave, Suite 100, Madison, WI 53705 Phone: 608-616-0118 Fax: 608-663-5928 | |
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