| Midwest Ctr For Psychotherapy & Sex Therapy | |
|
6300 University Ave Suite 125 Middleton WI 53562-3463 | |
| (608) 237-8000 | |
| (608) 237-8005 |
| Full Name | Midwest Ctr For Psychotherapy & Sex Therapy |
|---|---|
| Speciality | Clinic/Center |
| Location | 6300 University Ave, Middleton, Wisconsin |
| Authorized Official Name and Position | Jennifer Wilgocki (CORPORATION PRESIDENT) |
| Authorized Official Contact | 6082378000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Midwest Ctr For Psychotherapy & Sex Therapy 6300 University Ave Suite 125 Middleton WI 53562-3463 Ph: (608) 237-8000 | Midwest Ctr For Psychotherapy & Sex Therapy 6300 University Ave Suite 125 Middleton WI 53562-3463 Ph: (608) 237-8000 |
| NPI Number | 1619918877 |
|---|---|
| Provider Enumeration Date | 06/09/2006 |
| Last Update Date | 09/30/2014 |
| Medicare PECOS PAC ID | 4880660778 |
|---|---|
| Medicare Enrollment ID | O20040902000333 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619918877 | NPI | - | NPPES |
| 42172000 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | James K Gerndt |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1174544746 PECOS PAC ID: 0941259519 Enrollment ID: I20050120000884 |
| Provider Name | Shari A Cohn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619998218 PECOS PAC ID: 8628090503 Enrollment ID: I20051220000233 |
| Provider Name | Kathryn P Webster |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881613172 PECOS PAC ID: 0941214092 Enrollment ID: I20060127000745 |
| Provider Name | Dawn M Brubakken |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023313657 PECOS PAC ID: 1951523661 Enrollment ID: I20141113001118 |
| Provider Name | Bobbi Jo M Nichols |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396861837 PECOS PAC ID: 9234454984 Enrollment ID: I20150220002181 |
| Provider Name | Nick S Yackovich |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1497909733 PECOS PAC ID: 2567766629 Enrollment ID: I20160210000633 |
| Provider Name | Tarah L Liljeberg |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558741645 PECOS PAC ID: 3577826239 Enrollment ID: I20180410002036 |
| Provider Name | Jacob M Schuldies |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780843078 PECOS PAC ID: 0648600676 Enrollment ID: I20200415001491 |
| Provider Name | Meghan E Burge |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477224103 PECOS PAC ID: 8224420021 Enrollment ID: I20220127001185 |
| Provider Name | Jennifer Ann Miroslaw |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1588897466 PECOS PAC ID: 6204288459 Enrollment ID: I20240123004160 |
| Provider Name | Stephanie Lee Oestreich |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1942431622 PECOS PAC ID: 8123471562 Enrollment ID: I20240201001193 |
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