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1225 W Historic Mitchell St Suite 223 Milwaukee WI 53204-3383 | |
| (414) 383-4455 | |
| (414) 383-6759 |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 1225 W Historic Mitchell St, Milwaukee, Wisconsin |
| Authorized Official Name and Position | Wayne William Croatt (PRESIDENT) |
| Authorized Official Contact | 4143834455 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
1225 W Historic Mitchell St Suite 223 Milwaukee WI 53204-3383 Ph: (414) 383-4455 | 1225 W Historic Mitchell St Suite 223 Milwaukee WI 53204-3383 Ph: (414) 383-4455 |
| NPI Number | 1962575266 |
|---|---|
| Provider Enumeration Date | 11/16/2006 |
| Last Update Date | 12/01/2008 |
| Medicare PECOS PAC ID | 1850301672 |
|---|---|
| Medicare Enrollment ID | O20060425000071 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962575266 | NPI | - | NPPES |
| 42127400 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 1792 (Wisconsin) | Primary |
| Provider Name | Hugo F Goitia |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1417121153 PECOS PAC ID: 5597715946 Enrollment ID: I20050125000034 |
| Provider Name | Michael B Seeley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104849850 PECOS PAC ID: 5597773747 Enrollment ID: I20060329000423 |
| Provider Name | Robert E Lee |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386702124 PECOS PAC ID: 9537179973 Enrollment ID: I20060428000276 |
| Provider Name | Victoria A Mcginley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477997039 PECOS PAC ID: 2264672781 Enrollment ID: I20130705000359 |
| Provider Name | Jennifer H Price |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033387550 PECOS PAC ID: 1052617818 Enrollment ID: I20160304001334 |
| Provider Name | Susan M Williams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982926903 PECOS PAC ID: 3678580131 Enrollment ID: I20211104002156 |
| Provider Name | Janet Kamara |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568245637 PECOS PAC ID: 8921459181 Enrollment ID: I20240111004044 |
| Provider Name | Curt Clausen |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1912204884 PECOS PAC ID: 1951748292 Enrollment ID: I20240322001502 |
| Provider Name | Glenda Barber |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1902349905 PECOS PAC ID: 1658719463 Enrollment ID: I20240329000281 |
| Provider Name | Pamela L Banks |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1093168759 PECOS PAC ID: 5092247585 Enrollment ID: I20241022004318 |
Affirmative Reaction Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 6001 W Center St Ste 201, Milwaukee, WI 53210 Phone: 414-324-5318 | |
Stepping Stone Behavorial Health Clinic, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 7441 W Greenfield Ave, Suite 15, Milwaukee, WI 53214 Phone: 262-951-6969 | |
Sj Counseling Services, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 7726 N 80th St, Milwaukee, WI 53223 Phone: 414-841-5648 | |
Westcare Wisconsin, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 335 W Wright St, Milwaukee, WI 53212 Phone: 414-323-0185 | |
New Frontiers Psychiatric Sc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 2675 N Mayfair Rd Ste 400, Milwaukee, WI 53226 Phone: 414-763-6910 Fax: 414-763-6911 | |