| Wisconsin Community Services Inc. | |
|
3732 W Wisconsin Ave Ste 200 Milwaukee WI 53208-3166 | |
| (414) 344-6111 | |
| (414) 344-2191 |
| Full Name | Wisconsin Community Services Inc. |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 3732 W Wisconsin Ave Ste 200, Milwaukee, Wisconsin |
| Authorized Official Name and Position | Stephanie Compton (CONTROLLER) |
| Authorized Official Contact | 4142900420 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wisconsin Community Services Inc. 3734 W. Wisconsin Avenue Milwaukee WI 53208-3166 Ph: (414) 290-0400 | Wisconsin Community Services Inc. 3732 W Wisconsin Ave Ste 200 Milwaukee WI 53208-3166 Ph: (414) 344-6111 |
| NPI Number | 1538389184 |
|---|---|
| Provider Enumeration Date | 04/26/2007 |
| Last Update Date | 08/16/2024 |
| Certification Date | 08/16/2024 |
| Medicare PECOS PAC ID | 7517981822 |
|---|---|
| Medicare Enrollment ID | O20060125000244 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538389184 | NPI | - | NPPES |
| 42107800 | Medicaid | WI |
| Provider Name | Michael J Ewing |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1104922525 PECOS PAC ID: 6406823665 Enrollment ID: I20040916000141 |
| Provider Name | Stephen K Sponagle |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1255382925 PECOS PAC ID: 1658320957 Enrollment ID: I20050113000480 |
| Provider Name | Anne M Dunn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073611240 PECOS PAC ID: 9537167879 Enrollment ID: I20061120000441 |
| Provider Name | Shmuel Mandelbaum |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942221601 PECOS PAC ID: 2062542111 Enrollment ID: I20110307001012 |
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