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22 N Pelham Str. Rhinelander WI 54501 | |
| (715) 365-6696 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 22 N Pelham Str., Rhinelander, Wisconsin |
| Authorized Official Name and Position | Rita Jean Semmerling (OWNER) |
| Authorized Official Contact | 7153656696 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
22 N Pelham Str. Po Box 565 Rhinelander WI 54501 Ph: (715) 365-6696 | 22 N Pelham Str. Rhinelander WI 54501 Ph: (715) 365-6696 |
| NPI Number | 1467967489 |
|---|---|
| Provider Enumeration Date | 12/13/2017 |
| Last Update Date | 09/04/2024 |
| Certification Date | 08/15/2024 |
| Medicare PECOS PAC ID | 8123389525 |
|---|---|
| Medicare Enrollment ID | O20180227002761 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467967489 | NPI | - | NPPES |
| 100074986 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 100053038 (Wisconsin) | Secondary |
| 251S00000X | Community/behavioral Health | 100053038 (Wisconsin) | Primary |
| Provider Name | Rita Jean Semmerling |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1639535115 PECOS PAC ID: 6305107707 Enrollment ID: I20240920003421 |
| Provider Name | Lynn A Feldman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1578897633 PECOS PAC ID: 0143752832 Enrollment ID: I20241018003062 |
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