| Psychotherapy & Growth Center | |
|
660 W Washington Ave Suite #307 Madison WI 53703-4703 | |
| (608) 255-0669 | |
| (608) 255-0667 |
| Full Name | Psychotherapy & Growth Center |
|---|---|
| Speciality | Social Worker |
| Location | 660 W Washington Ave, Madison, Wisconsin |
| Authorized Official Name and Position | Kim Lauree Schutt-chardon (ADMINISTRATOR) |
| Authorized Official Contact | 6087707792 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Psychotherapy & Growth Center 660 W Washington Ave Suite #307 Madison WI 53703-4703 Ph: (608) 255-0669 | Psychotherapy & Growth Center 660 W Washington Ave Suite #307 Madison WI 53703-4703 Ph: (608) 255-0669 |
| NPI Number | 1184893752 |
|---|---|
| Provider Enumeration Date | 02/27/2008 |
| Last Update Date | 02/27/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184893752 | NPI | - | NPPES |
| 42164400 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | 1393123 (Wisconsin) | Primary |
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