| Independent Psychiatric Consultants Mental Health Center | |
|
2717 N Grandview Blvd Ste 102 Waukesha WI 53188-1672 | |
| (262) 513-0700 | |
| (262) 513-0707 |
| Full Name | Independent Psychiatric Consultants Mental Health Center |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2717 N Grandview Blvd Ste 102, Waukesha, Wisconsin |
| Authorized Official Name and Position | Cary J Kohlenberg (OWNER) |
| Authorized Official Contact | 2625130700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Independent Psychiatric Consultants Mental Health Center 2717 N Grandview Blvd Ste 102 Waukesha WI 53188-1672 Ph: (262) 513-0700 | Independent Psychiatric Consultants Mental Health Center 2717 N Grandview Blvd Ste 102 Waukesha WI 53188-1672 Ph: (262) 513-0700 |
| NPI Number | 1952487506 |
|---|---|
| Provider Enumeration Date | 10/27/2006 |
| Last Update Date | 10/30/2024 |
| Certification Date | 10/30/2024 |
| Medicare PECOS PAC ID | 9537140611 |
|---|---|
| Medicare Enrollment ID | O20040525001388 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952487506 | NPI | - | NPPES |
| 21300600 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Holly Reich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306922919 PECOS PAC ID: 6002897196 Enrollment ID: I20040525001454 |
| Provider Name | Kathleen M Glaser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225170392 PECOS PAC ID: 3274514179 Enrollment ID: I20040526001391 |
| Provider Name | Renee S Wenzlaff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124271549 PECOS PAC ID: 3870553977 Enrollment ID: I20041013000784 |
| Provider Name | Cary Jay Kohlenberg |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1427134089 PECOS PAC ID: 3971574674 Enrollment ID: I20050414000425 |
| Provider Name | Dianna M Susitti |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477653533 PECOS PAC ID: 7416994041 Enrollment ID: I20050414000544 |
| Provider Name | Peder N Piering |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1013920842 PECOS PAC ID: 7214943091 Enrollment ID: I20060302000703 |
| Provider Name | David J Rohde |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528086220 PECOS PAC ID: 2062416100 Enrollment ID: I20081002000482 |
| Provider Name | Carol J Adamczyk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457502395 PECOS PAC ID: 0345305744 Enrollment ID: I20090219000120 |
| Provider Name | Cindy I Damon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073628269 PECOS PAC ID: 3375675747 Enrollment ID: I20100720000991 |
| Provider Name | Matthew Robert Herald |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275737199 PECOS PAC ID: 7810166824 Enrollment ID: I20110809000328 |
| Provider Name | Caryl A Giuliani |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780967729 PECOS PAC ID: 0749436145 Enrollment ID: I20120816000770 |
| Provider Name | Kathryn Dvorak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215278221 PECOS PAC ID: 6608013081 Enrollment ID: I20130501000495 |
| Provider Name | Terrill L Bruett |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1922194737 PECOS PAC ID: 1759522964 Enrollment ID: I20130731000585 |
| Provider Name | Jessica A Angove |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508234188 PECOS PAC ID: 6901115955 Enrollment ID: I20151014002245 |
| Provider Name | Sandra K Arens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528318870 PECOS PAC ID: 3476774076 Enrollment ID: I20160126002590 |
| Provider Name | Shayla Jefferson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669926564 PECOS PAC ID: 4880975200 Enrollment ID: I20171201002010 |
| Provider Name | Angeline A Foster |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124671300 PECOS PAC ID: 1658602628 Enrollment ID: I20191007002113 |
| Provider Name | Solomon Demby |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114682424 PECOS PAC ID: 2769876655 Enrollment ID: I20220217002406 |
| Provider Name | Moireen Janice Ring |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093570046 PECOS PAC ID: 4880034255 Enrollment ID: I20240502000607 |
Allied Counseling Services, S.c. Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 2717 N Grandview Blvd Ste 202, Waukesha, WI 53188 Phone: 262-751-5672 Fax: 855-702-2180 | |
Catholic Charities Of The Archdiocese Of Milwaukee Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 717 N East Ave, Waukesha, WI 53186 Phone: 262-547-2463 Fax: 262-547-8002 | |
Summit Medical Specialists, Sc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2717 N Grandview Blvd Ste 202, Waukesha, WI 53188 Phone: 262-513-0700 Fax: 262-513-0707 | |
Waukesha County (ccs) Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1501 Airport Rd, Waukesha, WI 53188 Phone: 262-548-7950 Fax: 262-970-4791 | |
Children's Service Society Of Wisconsin Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 223 Wisconsin Ave, Suite D, Waukesha, WI 53186 Phone: 262-544-5333 Fax: 262-544-5393 | |
La Casa De Esperanza Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 210 Nw Barstow St, Suite 110, Waukesha, WI 53188 Phone: 262-928-4402 Fax: 262-928-7340 | |
Wisconsin Lutheran Child & Family Service, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 601 E College Ave, Waukesha, WI 53186 Phone: 800-438-1772 Fax: 262-345-5562 |