| Southwest Counseling | |
|
1160 Lincoln Ave Fennimore WI 53809-1746 | |
| (608) 822-5052 | |
| (608) 822-0131 |
| Full Name | Southwest Counseling |
|---|---|
| Speciality | Social Worker |
| Location | 1160 Lincoln Ave, Fennimore, Wisconsin |
| Authorized Official Name and Position | Regina Ann Trollop (OWNER) |
| Authorized Official Contact | 6087786978 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southwest Counseling 1160 Lincoln Ave Fennimore WI 53809-1746 Ph: (608) 822-5052 | Southwest Counseling 1160 Lincoln Ave Fennimore WI 53809-1746 Ph: (608) 822-5052 |
| NPI Number | 1306251640 |
|---|---|
| Provider Enumeration Date | 06/25/2014 |
| Last Update Date | 09/30/2020 |
| Certification Date | 09/30/2020 |
| Medicare PECOS PAC ID | 3072738335 |
|---|---|
| Medicare Enrollment ID | O20140701000695 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306251640 | NPI | - | NPPES |
| 39613700 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 384 (Wisconsin) | Primary |
| Provider Name | Regina A Trollop |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447360276 PECOS PAC ID: 3072553775 Enrollment ID: I20050511000707 |
| Provider Name | Nicole M Kaiser |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184051807 PECOS PAC ID: 1850791732 Enrollment ID: I20210615000781 |
| Provider Name | Michelle Cathlea Atterbury |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578127247 PECOS PAC ID: 3375998859 Enrollment ID: I20231018003990 |
| Provider Name | Megan Lynn Wolf |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1669860060 PECOS PAC ID: 8426494543 Enrollment ID: I20240312001949 |
| Provider Name | Jennifer Schoepp |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1427507730 PECOS PAC ID: 5799121612 Enrollment ID: I20240313002185 |
Fennimore Healing Arts, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 770 Lincoln Ave, Suite 2, Fennimore, WI 53809 Phone: 608-572-3494 Fax: 608-822-3812 |