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18000 W Sarah Ln Brookfield WI 53045-5853 | |
| (201) 364-7201 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Counselor |
| Location | 18000 W Sarah Ln, Brookfield, Wisconsin |
| Authorized Official Name and Position | Syed Hussaini (MEDICAL DIRECTOR) |
| Authorized Official Contact | 2013647201 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 233 Brookfield WI 53008-0233 Ph: (201) 364-7201 | 18000 W Sarah Ln Brookfield WI 53045-5853 Ph: (201) 364-7201 |
| NPI Number | 1689444028 |
|---|---|
| Provider Enumeration Date | 01/08/2024 |
| Last Update Date | 10/15/2024 |
| Certification Date | 10/15/2024 |
| Medicare PECOS PAC ID | 9638602741 |
|---|---|
| Medicare Enrollment ID | O20241029000367 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689444028 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Meredith Stoner Heath |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932558921 PECOS PAC ID: 2860747037 Enrollment ID: I20180613000114 |
| Provider Name | Catherine A Dupar Skelly |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912326190 PECOS PAC ID: 9335438340 Enrollment ID: I20190131001484 |
| Provider Name | Susan M Kalensky |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1710908405 PECOS PAC ID: 1759732191 Enrollment ID: I20240110000687 |
| Provider Name | Haley Lynn Lemire |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1821662818 PECOS PAC ID: 5991157026 Enrollment ID: I20240115000033 |
| Provider Name | Joseph M Halaiko |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1740791532 PECOS PAC ID: 4587197215 Enrollment ID: I20241101001799 |
| Provider Name | Elizabeth Jean Johnson |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1285257683 PECOS PAC ID: 7719410828 Enrollment ID: I20241205000498 |
| Provider Name | Susan Marie Condon |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1023669926 PECOS PAC ID: 8628501731 Enrollment ID: I20241205000780 |
| Provider Name | Sariya Marie Treske |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1326689639 PECOS PAC ID: 5597291187 Enrollment ID: I20241205003231 |
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