| Satellite Office--715 Hill Street, Madison 53705 | |
|
715 Hill St Madison WI 53705-3542 | |
| (608) 238-5535 | |
| (608) 238-7294 |
| Full Name | Satellite Office--715 Hill Street, Madison 53705 |
|---|---|
| Speciality | Counselor |
| Location | 715 Hill St, Madison, Wisconsin |
| Authorized Official Name and Position | James F Mcgloin (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6082312008 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Satellite Office--715 Hill Street, Madison 53705 702 N Blackhawk Ave Ste 104 Madison WI 53705-3357 Ph: (608) 238-5535 | Satellite Office--715 Hill Street, Madison 53705 715 Hill St Madison WI 53705-3542 Ph: (608) 238-5535 |
| NPI Number | 1912004516 |
|---|---|
| Provider Enumeration Date | 09/18/2006 |
| Last Update Date | 01/28/2015 |
| Medicare PECOS PAC ID | 0143308536 |
|---|---|
| Medicare Enrollment ID | O20080425000220 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912004516 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 91-123 (Wisconsin) | Primary |
| Provider Name | Mary P Moskoff |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134399819 PECOS PAC ID: 9335227719 Enrollment ID: I20080425000201 |
| Provider Name | James F Mcgloin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831335967 PECOS PAC ID: 1456670512 Enrollment ID: I20150512001784 |
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