| Samaritan Counseling Center Of The Fox Valley, Inc. | |
|
1205 Province Ter Menasha WI 54952-7017 | |
| (920) 886-9319 | |
| (920) 486-5340 |
| Full Name | Samaritan Counseling Center Of The Fox Valley, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 1205 Province Ter, Menasha, Wisconsin |
| Authorized Official Name and Position | Patty Eichhorst (FINANCE & ADMINISTRATION DIRECTOR) |
| Authorized Official Contact | 9208869319 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Samaritan Counseling Center Of The Fox Valley, Inc. 1205 Province Ter Menasha WI 54952-7017 Ph: (920) 886-9319 | Samaritan Counseling Center Of The Fox Valley, Inc. 1205 Province Ter Menasha WI 54952-7017 Ph: (920) 886-9319 |
| NPI Number | 1538175195 |
|---|---|
| Provider Enumeration Date | 08/01/2006 |
| Last Update Date | 02/08/2023 |
| Certification Date | 02/08/2023 |
| Medicare PECOS PAC ID | 9234034349 |
|---|---|
| Medicare Enrollment ID | O20031203000132 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538175195 | NPI | - | NPPES |
| 42181900 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 1355 (Wisconsin) | Primary |
| Provider Name | Diane M Savides |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932117488 PECOS PAC ID: 7113995598 Enrollment ID: I20040923000123 |
| Provider Name | Christy L Webster |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548496755 PECOS PAC ID: 5799063285 Enrollment ID: I20161103002498 |
| Provider Name | Elysabeth Meehan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700315884 PECOS PAC ID: 2466795059 Enrollment ID: I20190522003090 |
| Provider Name | Melissa Klosterman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275194474 PECOS PAC ID: 5496149692 Enrollment ID: I20220304001072 |
| Provider Name | Kayla Powers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619573821 PECOS PAC ID: 6507230968 Enrollment ID: I20230327000428 |
| Provider Name | Courtney Pohlman |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1972028850 PECOS PAC ID: 5799135372 Enrollment ID: I20231221003751 |
| Provider Name | Sergio Guerrero |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1053064097 PECOS PAC ID: 7315398781 Enrollment ID: I20240110001833 |
| Provider Name | Debra Kline |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1144679465 PECOS PAC ID: 7618328824 Enrollment ID: I20240111002064 |
| Provider Name | Douglas Bisbee |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1659651073 PECOS PAC ID: 2668823733 Enrollment ID: I20240112003088 |
| Provider Name | Kate Mary Mccarthy |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1316186141 PECOS PAC ID: 4981056926 Enrollment ID: I20240116001716 |
| Provider Name | Hannah Keesler |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1548691348 PECOS PAC ID: 4789037854 Enrollment ID: I20240125002162 |
| Provider Name | Michaela Monteverde |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1801550900 PECOS PAC ID: 0345684775 Enrollment ID: I20240214000167 |
| Provider Name | Ashley Vandyck |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1831777101 PECOS PAC ID: 9234573668 Enrollment ID: I20240214000207 |
| Provider Name | Megan J. Burdick-grade |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1235149642 PECOS PAC ID: 7618311069 Enrollment ID: I20240214000870 |
| Provider Name | John Barajas |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1003484478 PECOS PAC ID: 6901245596 Enrollment ID: I20240416000672 |
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