| Pine Valley Services | |
|
124 Grayside Ave Mauston WI 53948-1913 | |
| (608) 847-7575 | |
| (608) 847-3096 |
| Full Name | Pine Valley Services |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 124 Grayside Ave, Mauston, Wisconsin |
| Authorized Official Name and Position | Jessica Schulz (CEO / OWNER MEMBER LLC) |
| Authorized Official Contact | 6088477575 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pine Valley Services Po Box 359 Mauston WI 53948-0359 Ph: (608) 847-7575 | Pine Valley Services 124 Grayside Ave Mauston WI 53948-1913 Ph: (608) 847-7575 |
| NPI Number | 1013375104 |
|---|---|
| Provider Enumeration Date | 02/03/2016 |
| Last Update Date | 08/28/2023 |
| Certification Date | 08/28/2023 |
| Medicare PECOS PAC ID | 2769777911 |
|---|---|
| Medicare Enrollment ID | O20160826000873 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013375104 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Roberta A Bronecki |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205830965 PECOS PAC ID: 7810951852 Enrollment ID: I20041118000577 |
| Provider Name | Corinne Billet |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871115485 PECOS PAC ID: 7214358332 Enrollment ID: I20200528000279 |
| Provider Name | Genevieve Helen Geffert |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1437797958 PECOS PAC ID: 7012369341 Enrollment ID: I20240123000097 |
Heart Line Counseling And Consulting, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 522 Gateway Ave Ste F, Mauston, WI 53948 Phone: 608-285-2133 Fax: 608-716-3155 | |
Inside/out Psychological Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 102 W State St, Mauston, WI 53948 Phone: 608-847-7924 Fax: 608-847-7925 |