| Nystrom & Associates | |
|
201 Main St Ste 500 Lacrosse WI 54601 | |
| (651) 379-1750 | |
| (651) 628-0411 |
| Full Name | Nystrom & Associates |
|---|---|
| Speciality | Clinic/Center |
| Location | 201 Main St, Lacrosse, Wisconsin |
| Authorized Official Name and Position | Mark James Peterson (CEO) |
| Authorized Official Contact | 6516289566 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Nystrom & Associates 1900 Silver Lake Rd New Brighton MN 55112 Ph: (651) 379-1750 | Nystrom & Associates 201 Main St Ste 500 Lacrosse WI 54601 Ph: (651) 379-1750 |
| NPI Number | 1659977866 |
|---|---|
| Provider Enumeration Date | 12/11/2020 |
| Last Update Date | 10/24/2023 |
| Certification Date | 10/24/2023 |
| Medicare PECOS PAC ID | 1052729464 |
|---|---|
| Medicare Enrollment ID | O20210426000171 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659977866 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Laura L Stresow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306833348 PECOS PAC ID: 7012806581 Enrollment ID: I20040312000568 |
| Provider Name | Andrew J Wolf |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871668723 PECOS PAC ID: 4587560529 Enrollment ID: I20040617000772 |
| Provider Name | Kevin J Rooney |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1215910310 PECOS PAC ID: 9436108735 Enrollment ID: I20050113000432 |
| Provider Name | Jennifer L Mueller |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1629011697 PECOS PAC ID: 0446337422 Enrollment ID: I20080402000350 |
| Provider Name | Lynn A Wilson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972554798 PECOS PAC ID: 4880880327 Enrollment ID: I20101123001135 |
| Provider Name | Denise M Matel Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598012619 PECOS PAC ID: 4183877426 Enrollment ID: I20130116000467 |
| Provider Name | Bridget Long |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619289907 PECOS PAC ID: 1456596733 Enrollment ID: I20130315000250 |
| Provider Name | Roberta A Goodman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1811251556 PECOS PAC ID: 1254321797 Enrollment ID: I20160210000041 |
| Provider Name | Victoria A Zwiefelhofer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528414034 PECOS PAC ID: 4880983295 Enrollment ID: I20160524001090 |
| Provider Name | Ryan T Stepp |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1881954816 PECOS PAC ID: 2961799424 Enrollment ID: I20160927001437 |
| Provider Name | Kerry A Talbert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336691062 PECOS PAC ID: 0840570396 Enrollment ID: I20161129002421 |
| Provider Name | Nicole C Li |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689943250 PECOS PAC ID: 1052694288 Enrollment ID: I20170213001622 |
| Provider Name | Kathryn A Wingate |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265915250 PECOS PAC ID: 6204180540 Enrollment ID: I20181126001796 |
| Provider Name | Geoffrey K Malone |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699293563 PECOS PAC ID: 5799193264 Enrollment ID: I20210421002842 |
| Provider Name | Donna M Christianson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598938151 PECOS PAC ID: 1759799166 Enrollment ID: I20210426000246 |
| Provider Name | Jonathan C Uecker |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659334092 PECOS PAC ID: 5193786614 Enrollment ID: I20210427000720 |
| Provider Name | Megan A Septer |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1114043627 PECOS PAC ID: 2567506421 Enrollment ID: I20210623002656 |
| Provider Name | Coleen R Christensen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396237764 PECOS PAC ID: 5496005456 Enrollment ID: I20210804000018 |
| Provider Name | Nicole Y Anderson |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1902489339 PECOS PAC ID: 1456751866 Enrollment ID: I20210805001893 |
| Provider Name | Leanne E Rohlf |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427440767 PECOS PAC ID: 0042539520 Enrollment ID: I20210806001050 |
| Provider Name | Richard A Blackburn |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1134293400 PECOS PAC ID: 0345242657 Enrollment ID: I20210831002593 |
| Provider Name | Kathlyn Jeannette Bergeron |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720420243 PECOS PAC ID: 5395987820 Enrollment ID: I20210831003075 |
| Provider Name | Evelyn Ndafooka |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336815190 PECOS PAC ID: 9436556651 Enrollment ID: I20210930000343 |
| Provider Name | Valerie J Both |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417436569 PECOS PAC ID: 5395143721 Enrollment ID: I20211014002695 |
| Provider Name | Paul C Brown |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386825867 PECOS PAC ID: 7810385218 Enrollment ID: I20211103001755 |
| Provider Name | Jessica J Modjeski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114687860 PECOS PAC ID: 9638561772 Enrollment ID: I20220121000790 |
| Provider Name | Kelly Szozda Swartos |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033876602 PECOS PAC ID: 1153713953 Enrollment ID: I20220127001114 |
| Provider Name | Tiffany M Foley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669908638 PECOS PAC ID: 4981016540 Enrollment ID: I20220610001722 |
| Provider Name | Kelly R Hemmer-rondestvedt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669751079 PECOS PAC ID: 7719152628 Enrollment ID: I20220613002766 |
| Provider Name | Kristen K Foehner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235365420 PECOS PAC ID: 7315326212 Enrollment ID: I20220623001982 |
| Provider Name | Sarah Jean Motacek |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184089864 PECOS PAC ID: 5092198135 Enrollment ID: I20220822003632 |
| Provider Name | Brynn A Sytsma |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1619594355 PECOS PAC ID: 8921484304 Enrollment ID: I20221009000055 |
| Provider Name | Casey Coughlin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790134625 PECOS PAC ID: 8921478264 Enrollment ID: I20230103002448 |
| Provider Name | Amy L Kuritz |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1205546918 PECOS PAC ID: 1153793757 Enrollment ID: I20230208000844 |
| Provider Name | Leila L Pinter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326777095 PECOS PAC ID: 0244604940 Enrollment ID: I20230321000399 |
| Provider Name | Mary Q Stample |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750096145 PECOS PAC ID: 3274907613 Enrollment ID: I20230324002510 |
| Provider Name | Angela Khalar |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831549260 PECOS PAC ID: 3779875356 Enrollment ID: I20230328000193 |
| Provider Name | Kendra A Seitz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104539402 PECOS PAC ID: 5395119861 Enrollment ID: I20230329001664 |
| Provider Name | Heather J Mask |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942372859 PECOS PAC ID: 1658758883 Enrollment ID: I20230801003892 |
| Provider Name | Kalene N Ruemler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295345437 PECOS PAC ID: 0941664882 Enrollment ID: I20230912001074 |
| Provider Name | Heather L Bodurtha |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1679774673 PECOS PAC ID: 8729187331 Enrollment ID: I20230928000402 |
| Provider Name | Cindy L Stuhmer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255834180 PECOS PAC ID: 3476907932 Enrollment ID: I20231002003438 |
| Provider Name | Kristin Renee Murphy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548619521 PECOS PAC ID: 8426315359 Enrollment ID: I20231010003596 |
| Provider Name | Jenny Esther Clark |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023531241 PECOS PAC ID: 8527413384 Enrollment ID: I20231013001587 |
| Provider Name | Erica L Micele |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841961570 PECOS PAC ID: 3476907304 Enrollment ID: I20231013001968 |
| Provider Name | Amy M Koehler-killeen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811684632 PECOS PAC ID: 7012371842 Enrollment ID: I20231017001488 |
| Provider Name | Amy J Schwab |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013493345 PECOS PAC ID: 1850641978 Enrollment ID: I20231103000779 |
| Provider Name | Brent M Gust |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295403244 PECOS PAC ID: 1850748591 Enrollment ID: I20231117000052 |
| Provider Name | Giuseppe F Malfi |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1104381797 PECOS PAC ID: 9133579725 Enrollment ID: I20231222000094 |
| Provider Name | Kelsey Dillon |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1295184083 PECOS PAC ID: 2163872862 Enrollment ID: I20231222001530 |
| Provider Name | Robert John Booth |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1831768258 PECOS PAC ID: 6608226238 Enrollment ID: I20231222001843 |
| Provider Name | Derek M Daanen |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1124890470 PECOS PAC ID: 1254781776 Enrollment ID: I20231226001671 |
| Provider Name | Kalana L Graham |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851062855 PECOS PAC ID: 0446600761 Enrollment ID: I20231229000343 |
| Provider Name | Krista W Von Feldt |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1528524006 PECOS PAC ID: 1456702307 Enrollment ID: I20240104004571 |
| Provider Name | Sarah J Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275221368 PECOS PAC ID: 5597121764 Enrollment ID: I20240117000232 |
| Provider Name | Anne M Allen |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1881623403 PECOS PAC ID: 7214389923 Enrollment ID: I20240118001683 |
| Provider Name | Elyse Hoehn |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1649820168 PECOS PAC ID: 9234581968 Enrollment ID: I20240118002378 |
| Provider Name | Meghan Schweinhagen |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1679949713 PECOS PAC ID: 8426400953 Enrollment ID: I20240119001537 |
| Provider Name | Jennifer Jeanette Rodewald |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1609466523 PECOS PAC ID: 3476905670 Enrollment ID: I20240123002571 |
| Provider Name | Travis Heipp |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1972152361 PECOS PAC ID: 1456703685 Enrollment ID: I20240123003444 |
| Provider Name | Polly Scott |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1982271896 PECOS PAC ID: 1052763281 Enrollment ID: I20240123003616 |
| Provider Name | Erica Lynn Petry |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1336519255 PECOS PAC ID: 8224488754 Enrollment ID: I20240124000685 |
| Provider Name | Madeleine J Ipsen |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1417666777 PECOS PAC ID: 0941653133 Enrollment ID: I20240124000847 |
| Provider Name | Brock Conrad Klement |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1366107484 PECOS PAC ID: 2961855168 Enrollment ID: I20240124001132 |
| Provider Name | Luke M Schroeder |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1295306082 PECOS PAC ID: 5496108615 Enrollment ID: I20240124001925 |
| Provider Name | Tricia Ann Kerker |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1063796506 PECOS PAC ID: 5597118554 Enrollment ID: I20240126000894 |
| Provider Name | Jennifer Lynn Kastner |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1346765930 PECOS PAC ID: 4183077720 Enrollment ID: I20240130002406 |
| Provider Name | Christina Marie Holcomb |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1871892588 PECOS PAC ID: 2860835139 Enrollment ID: I20240205000679 |
| Provider Name | Katrina Elizabeth Gruber |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1063101723 PECOS PAC ID: 7911340161 Enrollment ID: I20240205003893 |
| Provider Name | Annelies L White |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1003274770 PECOS PAC ID: 0547603680 Enrollment ID: I20240206002845 |
| Provider Name | Jennifer L Wickham |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1215987847 PECOS PAC ID: 2567805625 Enrollment ID: I20240206003566 |
| Provider Name | Bryzena Ann Santos |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1881291821 PECOS PAC ID: 4880037647 Enrollment ID: I20240208001660 |
| Provider Name | Kevin Fisher |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1144570706 PECOS PAC ID: 5597108183 Enrollment ID: I20240212000347 |
| Provider Name | Timothy Ryan Foster |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1982148722 PECOS PAC ID: 3870936305 Enrollment ID: I20240212001985 |
| Provider Name | Elizabeth Davison |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1154894657 PECOS PAC ID: 7810330370 Enrollment ID: I20240212002902 |
| Provider Name | Joshua Thomas Paul |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1447638440 PECOS PAC ID: 8628412053 Enrollment ID: I20240214000136 |
| Provider Name | Colleen Michelle Gromowski |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1952475204 PECOS PAC ID: 5092159434 Enrollment ID: I20240214000485 |
| Provider Name | Stephanie Rafn |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1386998904 PECOS PAC ID: 5496105611 Enrollment ID: I20240214001847 |
| Provider Name | Rachel M Slough-johnson |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1801262563 PECOS PAC ID: 6709229651 Enrollment ID: I20240214003960 |
| Provider Name | Tanya L Kessen |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1003574252 PECOS PAC ID: 9436593274 Enrollment ID: I20240220001832 |
| Provider Name | Carrie Lois Main |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1366051344 PECOS PAC ID: 9931559218 Enrollment ID: I20240220003281 |
| Provider Name | Brittany Chantelle Vaughns |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1770080467 PECOS PAC ID: 3173967957 Enrollment ID: I20240220003448 |
| Provider Name | Susanne D Wesle |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1174147664 PECOS PAC ID: 9830533504 Enrollment ID: I20240221001888 |
| Provider Name | Crystal Skenandore |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1891308649 PECOS PAC ID: 2567806151 Enrollment ID: I20240222002078 |
| Provider Name | Vlatko Sagud |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1255891602 PECOS PAC ID: 6800231812 Enrollment ID: I20240229002869 |
| Provider Name | Kelsey Lynn Markham |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1942692520 PECOS PAC ID: 9234574112 Enrollment ID: I20240301001023 |
| Provider Name | Chelsea Eileen Deutsch |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205501855 PECOS PAC ID: 0345685087 Enrollment ID: I20240304002240 |
| Provider Name | Leah Marie Gray |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1699248757 PECOS PAC ID: 0941646210 Enrollment ID: I20240308001084 |
| Provider Name | Jennifer Ann Karper |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1477072684 PECOS PAC ID: 8729424809 Enrollment ID: I20240312000491 |
| Provider Name | Lindsay Anne Wittrock |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1275128837 PECOS PAC ID: 1052759776 Enrollment ID: I20240401001692 |
| Provider Name | Amy R Des Forge |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1982118550 PECOS PAC ID: 3476991704 Enrollment ID: I20240405002153 |
| Provider Name | Allison Carrie Harwood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285410845 PECOS PAC ID: 2860848827 Enrollment ID: I20240406000446 |
| Provider Name | Sarah E Barron |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1861133449 PECOS PAC ID: 7012355167 Enrollment ID: I20240409001156 |
| Provider Name | James Andrew Jozwiak |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154049062 PECOS PAC ID: 7618316183 Enrollment ID: I20240416004004 |
| Provider Name | Abigail S Russell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396473955 PECOS PAC ID: 3971942947 Enrollment ID: I20240424000363 |
| Provider Name | Krystal Coleman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1629511621 PECOS PAC ID: 0446690341 Enrollment ID: I20240425001426 |
| Provider Name | Stefanie F Vitucci |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740030295 PECOS PAC ID: 8325488430 Enrollment ID: I20240506001904 |
| Provider Name | Autumn Marie Schleis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1649948597 PECOS PAC ID: 2961844378 Enrollment ID: I20240530000520 |
| Provider Name | Hollie Christine Smet |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1275259293 PECOS PAC ID: 4789126244 Enrollment ID: I20240612000924 |
Changes And Choices Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2350 South Avenue, Suite 102, Lacrosse, WI 54601 Phone: 608-787-6645 Fax: 608-787-6658 | |
Human Development Associates Of Lacrosse Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2920 East Ave S, Suite 101, Lacrosse, WI 54601 Phone: 608-784-8688 Fax: 608-784-8684 | |
Red Feather Therapy And Consulting, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 2920 East Avenue South Suite 101, Red Feather Therapy And Consulting, Llc, Lacrosse, WI 54601 Phone: 608-784-8688 Fax: 608-784-8686 |