| Interpersonnel | |
|
401 Wisconsin Ave Madison WI 53703-1487 | |
| (608) 345-2273 | |
| (608) 256-5116 |
| Full Name | Interpersonnel |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 401 Wisconsin Ave, Madison, Wisconsin |
| Authorized Official Name and Position | Holly Jorgenson (OWNER) |
| Authorized Official Contact | 6083452273 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Interpersonnel 2205 Commonwealth Ave Madison WI 53726-5301 Ph: (608) 345-2273 | Interpersonnel 401 Wisconsin Ave Madison WI 53703-1487 Ph: (608) 345-2273 |
| NPI Number | 1861803512 |
|---|---|
| Provider Enumeration Date | 05/15/2014 |
| Last Update Date | 05/15/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861803512 | NPI | - | NPPES |
| 1659452571 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 4026123 (Wisconsin) | Primary |
| 101YP2500X | Counselor - Professional | 4026126 (Wisconsin) | Secondary |
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