Racine Psychological Services, Inc. | |
840 Lake Ave Suite 101 Racine WI 53403-1566 | |
(262) 634-8688 | |
(262) 634-7547 |
Full Name | Racine Psychological Services, Inc. |
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Speciality | Clinic/center - Adult Mental Health |
Location | 840 Lake Ave, Racine, Wisconsin |
Authorized Official Name and Position | Mary Jane Whitmore (DIRECTOR) |
Authorized Official Contact | 2626348688 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Racine Psychological Services, Inc. 840 Lake Ave Suite 101 Racine WI 53403-1566 Ph: (262) 634-8688 | Racine Psychological Services, Inc. 840 Lake Ave Suite 101 Racine WI 53403-1566 Ph: (262) 634-8688 |
NPI Number | 1275586323 |
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Provider Enumeration Date | 05/18/2006 |
Last Update Date | 04/20/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1275586323 | NPI | - | NPPES |
42216900 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0850X | Clinic/center - Adult Mental Health | 2220 (Wisconsin) | Primary |
Dynamic Potential Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 316 5th St Ste 2, Racine, WI 53403 Phone: 262-308-8085 | |
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Mwa Counseling Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4425 Taylor Ave, Racine, WI 53405 Phone: 262-554-1400 | |
Professional Services Group, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 800 Goold St, Racine, WI 53402 Phone: 262-638-2000 Fax: 262-638-2006 |