| Northstar Partnership | |
|
700 Ray O Vac Dr Ste 10 Madison WI 53711-2480 | |
| (608) 270-1960 | |
| (608) 270-1965 |
| Full Name | Northstar Partnership |
|---|---|
| Speciality | Counselor |
| Location | 700 Ray O Vac Dr Ste 10, Madison, Wisconsin |
| Authorized Official Name and Position | Heather Patti (OFFICE MANAGER) |
| Authorized Official Contact | 6082701960 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northstar Partnership 700 Ray O Vac Dr Ste 10 Madison WI 53711-2480 Ph: (608) 270-1960 | Northstar Partnership 700 Ray O Vac Dr Ste 10 Madison WI 53711-2480 Ph: (608) 270-1960 |
| NPI Number | 1932279593 |
|---|---|
| Provider Enumeration Date | 11/09/2006 |
| Last Update Date | 06/04/2013 |
| Medicare PECOS PAC ID | 9335108489 |
|---|---|
| Medicare Enrollment ID | O20041005001079 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932279593 | NPI | - | NPPES |
| 42209900 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 1685 (Wisconsin) | Primary |
| Provider Name | Sanjay Agarwal |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376721928 PECOS PAC ID: 1658428743 Enrollment ID: I20101122001135 |
| Provider Name | Steven R Stein |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1538195607 PECOS PAC ID: 1850350901 Enrollment ID: I20120412000519 |
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