| Wellness West Llc | |
|
2428 N Grandview Blvd Ste 101 Waukesha WI 53188-6906 | |
| (262) 259-4100 | |
| Not Available |
| Full Name | Wellness West Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2428 N Grandview Blvd Ste 101, Waukesha, Wisconsin |
| Authorized Official Name and Position | Jennifer Vann (OWNER/PSYCHOLOGIST) |
| Authorized Official Contact | 2622594100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wellness West Llc 2428 N Grandview Blvd Ste 101 Waukesha WI 53188-6906 Ph: (262) 259-4100 | Wellness West Llc 2428 N Grandview Blvd Ste 101 Waukesha WI 53188-6906 Ph: (262) 259-4100 |
| NPI Number | 1306569629 |
|---|---|
| Provider Enumeration Date | 09/21/2022 |
| Last Update Date | 09/21/2022 |
| Certification Date | 09/21/2022 |
| Medicare PECOS PAC ID | 4789052820 |
|---|---|
| Medicare Enrollment ID | O20221122001246 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306569629 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Amy C Gurka |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1578572335 PECOS PAC ID: 6507874872 Enrollment ID: I20110615000054 |
| Provider Name | Jennifer Vann |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1922451285 PECOS PAC ID: 5294077194 Enrollment ID: I20190424002405 |
| Provider Name | Patricia Torzala |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1689287385 PECOS PAC ID: 8224489497 Enrollment ID: I20240111004341 |
| Provider Name | Charles F Lawler |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1013094911 PECOS PAC ID: 3577735174 Enrollment ID: I20240318001261 |
Allied Counseling Services, S.c. Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 2717 N Grandview Blvd Ste 202, Waukesha, WI 53188 Phone: 262-751-5672 Fax: 855-702-2180 | |
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