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612 N Randall Ave Suite A Janesville WI 53545-1958 | |
| (608) 752-7660 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 612 N Randall Ave, Janesville, Wisconsin |
| Authorized Official Name and Position | Tara Treglowne (COO) |
| Authorized Official Contact | 4142462300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
1904 Winnebago St Fl 2 Madison WI 53704-5315 Ph: (608) 234-2074 | 612 N Randall Ave Suite A Janesville WI 53545-1958 Ph: (608) 752-7660 |
| NPI Number | 1386719177 |
|---|---|
| Provider Enumeration Date | 11/21/2006 |
| Last Update Date | 01/06/2025 |
| Certification Date | 01/06/2025 |
| Medicare PECOS PAC ID | 2668383084 |
|---|---|
| Medicare Enrollment ID | O20040204000700 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386719177 | NPI | - | NPPES |
| Provider Name | Samantha Feryance |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1073242863 PECOS PAC ID: 3072954478 Enrollment ID: I20240516002063 |
| Provider Name | Alyssa Senz |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1154892628 PECOS PAC ID: 9436692829 Enrollment ID: I20240613001334 |
| Provider Name | Brittany Nessel |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1356610489 PECOS PAC ID: 4880137306 Enrollment ID: I20240625000743 |
| Provider Name | Kathryn K Mattingly |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1255788196 PECOS PAC ID: 3678914264 Enrollment ID: I20240702002301 |
| Provider Name | Amy L Gleason |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1306495932 PECOS PAC ID: 0143768317 Enrollment ID: I20240819003857 |
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The Willows Counseling And Emdr Center, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 20 S Main St Ste 21, Janesville, WI 53545 Phone: 608-851-0348 Fax: 815-737-8115 | |
Bridgeway Psychological Associates Ltd. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 519 Midland Ct, Suite 102, Janesville, WI 53546 Phone: 608-756-9090 Fax: 608-756-2920 |