| Oakwood Clinical Associates, Ltd | |
|
4109 67th St Kenosha WI 53142-3836 | |
| (262) 652-9830 | |
| (262) 652-2931 |
| Full Name | Oakwood Clinical Associates, Ltd |
|---|---|
| Speciality | Clinic/Center |
| Location | 4109 67th St, Kenosha, Wisconsin |
| Authorized Official Name and Position | Amy B Anderson (PSYCHOTHERAPIST) |
| Authorized Official Contact | 2626529830 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Oakwood Clinical Associates, Ltd 4109 67th St Kenosha WI 53142-3836 Ph: (262) 652-9830 | Oakwood Clinical Associates, Ltd 4109 67th St Kenosha WI 53142-3836 Ph: (262) 652-9830 |
| NPI Number | 1447289434 |
|---|---|
| Provider Enumeration Date | 07/02/2006 |
| Last Update Date | 03/18/2015 |
| Medicare PECOS PAC ID | 8022084383 |
|---|---|
| Medicare Enrollment ID | O20040908000656 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447289434 | NPI | - | NPPES |
| 42157000 | Medicaid | WI | |
| 84521 | Other | WI | MEDICARE |
| Provider Name | Susan E Moore Schneider |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104901222 PECOS PAC ID: 5799721346 Enrollment ID: I20071108000100 |
| Provider Name | Amy Beth Anderson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295766186 PECOS PAC ID: 8022084391 Enrollment ID: I20100911000075 |
| Provider Name | Nyles Anthony Jackson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053637629 PECOS PAC ID: 7810204708 Enrollment ID: I20150909001658 |
| Provider Name | Michelle M Matthews |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528100641 PECOS PAC ID: 4385058742 Enrollment ID: I20210126000715 |
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