| Samaritan Counseling Center Of Southern Wisconsin | |
|
5900 Monona Dr Ste 100 Monona WI 53716-3556 | |
| (608) 663-0763 | |
| (608) 663-0765 |
| Full Name | Samaritan Counseling Center Of Southern Wisconsin |
|---|---|
| Speciality | Counselor |
| Location | 5900 Monona Dr Ste 100, Monona, Wisconsin |
| Authorized Official Name and Position | Dan Feaster (EXECTUTIVE DIRECTOR) |
| Authorized Official Contact | 6086630763 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Samaritan Counseling Center Of Southern Wisconsin 5900 Monona Dr Ste 100 Monona WI 53716-3556 Ph: (608) 663-0763 | Samaritan Counseling Center Of Southern Wisconsin 5900 Monona Dr Ste 100 Monona WI 53716-3556 Ph: (608) 663-0763 |
| NPI Number | 1962544353 |
|---|---|
| Provider Enumeration Date | 02/13/2007 |
| Last Update Date | 03/12/2008 |
| Medicare PECOS PAC ID | 3870558281 |
|---|---|
| Medicare Enrollment ID | O20041124000763 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962544353 | NPI | - | NPPES |
| 39405400 | Medicaid | WI | |
| 39567300 | Medicaid | WI | |
| 43592300 | Medicaid | WI | |
| 39127800 | Medicaid | WI | |
| 30237400 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | HFS 61.91 (Wisconsin) | Primary |
| Provider Name | Peter Thomas Laubach |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316953540 PECOS PAC ID: 0345292561 Enrollment ID: I20050216000514 |
| Provider Name | Suzanne Gruen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235376559 PECOS PAC ID: 9931257623 Enrollment ID: I20090507000317 |
| Provider Name | Dan G Feaster |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790985000 PECOS PAC ID: 1355306762 Enrollment ID: I20111220000698 |
| Provider Name | Jane E Mccauley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629491469 PECOS PAC ID: 2062796402 Enrollment ID: I20170301002617 |
| Provider Name | Matthew R Rozzi |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1679236137 PECOS PAC ID: 7810386125 Enrollment ID: I20211108000928 |
| Provider Name | Phillip Ross Buttner |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1881303444 PECOS PAC ID: 0244600229 Enrollment ID: I20230109001826 |
| Provider Name | William Badger |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1336575182 PECOS PAC ID: 0648610667 Enrollment ID: I20240424002315 |
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