| Icf Consultants, Inc. | |
|
1524 N Farwell Ave Milwaukee WI 53202-2329 | |
| (414) 273-2220 | |
| (414) 273-2223 |
| Full Name | Icf Consultants, Inc. |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 1524 N Farwell Ave, Milwaukee, Wisconsin |
| Authorized Official Name and Position | Marilyn Jeanne Bonjean (PRESIDENT) |
| Authorized Official Contact | 4142732220 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Icf Consultants, Inc. 1524 N Farwell Ave Milwaukee WI 53202-2329 Ph: (414) 273-2220 | Icf Consultants, Inc. 1524 N Farwell Ave Milwaukee WI 53202-2329 Ph: (414) 273-2220 |
| NPI Number | 1962568998 |
|---|---|
| Provider Enumeration Date | 12/27/2006 |
| Last Update Date | 07/05/2023 |
| Certification Date | 07/05/2023 |
| Medicare PECOS PAC ID | 9234028168 |
|---|---|
| Medicare Enrollment ID | O20040310001493 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962568998 | NPI | - | NPPES |
| 42145500 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 1429 (Wisconsin) | Primary |
| Provider Name | Karen A Jick |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336462241 PECOS PAC ID: 8224160650 Enrollment ID: I20100720000521 |
| Provider Name | Ivaylo I Hristov |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255405320 PECOS PAC ID: 4486813029 Enrollment ID: I20120316000585 |
| Provider Name | Patricia Anne White |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1912036609 PECOS PAC ID: 7214479252 Enrollment ID: I20240606000568 |
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