THE REDI CLINIC OF WAUWATOSA, SC (NPI# 1043228505) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043228505 |
| Entity Type | Organization |
| Organization Name | THE REDI CLINIC OF WAUWATOSA, SC |
| Other Organization Name | PATHWAY CLINIC, SC |
| Practice Address |
2500 N. Mayfair Rd, Ste 600 Wauwatosa WI 53226 |
| Practice Telephone | 4147274455 |
| Practice Fax Number | 4147274690 |
| Mailing Telephone | 4147274455 |
| Mailing Fax Number | 4147274690 |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2017-04-18 |
| Authorized Official Name | THEODORE WELTZIN (CO-OWNER) |
| Authorized Official Telephone | 4147274455 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YM0800X |
Counselor Specialization: Mental Health |
1729 | WI | Behavioral Health & Social Service Providers |
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
1729 | WI | Behavioral Health & Social Service Providers |
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 1043228505 | 05 | |
| WI | MEDICARE GROUP NUMBER | 84793 | 01 |
| WI | 42127100 | 05 |
| Other Name | Type Code |
|---|---|
| Pathway Clinic, SC | Former Legal Business Name - Organization |
| Street Address |
2500 N. MAYFAIR RD, STE 600 |
| City | WAUWATOSA |
| State | WI |
| Zip Code | 53226 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912511155 | Alexander Harlan | Pharmacist | 900 N 92nd St, Milwaukee, WI 53226 | 2020-09-04 |
| 1558985762 | Armghan Haider Ans | Student in an Organized Health Care Education/Training Program | 9200 W. Wisconsin Ave. Froedtert Hospital & Medical Col, Milwaukee, WI 53226 | 2020-06-03 |
| 1669001103 | Kimberly Tyler | Student in an Organized Health Care Education/Training Program | 8701 W Watertown Plank Road, Medical College of Wisconsin Dept of Internal Medicine, Wauwatosa, WI 53226 | 2020-04-06 |
| 1972131993 | Francesca Meloy Devine | Student in an Organized Health Care Education/Training Program | Medical Education Office: Children's Corporate Center, 999 N. 92nd St., Suite 730, Milwaukee, WI 53226 | 2020-03-27 |
| 1285275248 | Sharitta Alford | Technician | 12250 West North Avenue, Apartment 142b, Wauwatosa, WI 53226 | 2019-10-01 |
| 1619528023 | Linda Marie Sabatinelli | Technician | 12107 W. Woodland Ave, Wauwatosa, WI 53226 | 2019-09-26 |
| 1598310195 | Matthew Laviolette | Surgery | Medical College of Wisconsin, 8701 Watertown Plank Rd., Surgical Oncology, Milwaukee, WI 53226 | 2019-08-09 |
| 1962056432 | Lyndsey Marie Bratberg | Physician Assistant | F&mcw Clinical Cancer Center 9200 W. Wisconsin Ave., Milwaukee, WI 53226 | 2019-08-01 |
| 1659832855 | Benjamin David Seadler | Surgery | Mcw, Department of Surgery, 8701 Watertown Plank Road, Milwaukee, WI 53226 | 2019-03-29 |
| 1861953267 | Michael Dryden | Student in an Organized Health Care Education/Training Program | 8701 Watertown Plank Rd., Milwaukee, WI 53226 | 2019-03-27 |
| Find all providers in zip 53226 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598276719 | Core Center for Couples and Therapy Services, LLC | Clinic/Center | 10855 W Potter Rd Ste 23, Wauwatosa, WI 53226-3439 | 2017-10-15 |
| 1285264424 | Jill E Greinke Psychotherapist LLC | Clinic/Center | 933 N Mayfair Rd Ste 101, Wauwatosa, WI 53226-3432 | 2020-01-15 |
| 1336628346 | Dr Michelle L Iyamah Psychodiagnostics LLC | Clinic/Center | 933 N Mayfair Rd Ste 101, Wauwatosa, WI 53226-3432 | 2018-08-09 |
| 1073722211 | Summit Psychology Clinic Sc | Clinic/Center | 933 N Mayfair Rd, Ste 303, Wauwatosa, WI 53226 | 2007-05-22 |
| 1902021512 | Bernadette Mullins Miller LLC | Clinic/Center | 2600 N Mayfair Rd Ste 305, Wauwatosa, WI 53226-1303 | 2007-04-17 |
| 1174684872 | Valentin Clinic Sc | Clinic/Center | 1220 Dewey Avenue, Wauwatosa, WI 53213-2504 | 2006-12-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477151439 | Tetzlaff & Myhre Psychotherapy and Assessments, LLC | Clinic/Center | N55w37178 Roland St, Oconomowoc, WI 53066-5321 | 2020-10-13 |
| 1598377244 | Calming Journeys Counseling, S.c. | Clinic/Center | 220 Wisconsin Dells Pkwy S Ste 1, Wisconsin Dells, WI 53965-8305 | 2020-08-23 |
| 1811509979 | Natural Wisdom Counseling LLC | Clinic/Center | 1523 Wi-78 Trunk, Mount Horeb, WI 53572 | 2020-08-20 |
| 1245841089 | Integrated Counseling LLC | Clinic/Center | 7818 Big Sky Dr Ste 214, Madison, WI 53719-2840 | 2020-08-14 |
| 1629687108 | Premier Medical & Couple Therapy | Clinic/Center | 1025 W Glen Oaks Ln Ste 208, Mequon, WI 53092-3374 | 2020-07-30 |
| 1841809878 | Lifespan Psychotherapy | Clinic/Center | 510 Hartbrook Dr Ste 204b, Hartland, WI 53029-1440 | 2020-07-27 |
| 1114535929 | Eclipse Counseling LLC | Clinic/Center | 1136 Barron St, Eau Claire, WI 54703 | 2020-07-17 |
| 1275164709 | Katrina M. Johnson, LLC | Clinic/Center | 106 Passive Sun Drive, Soldiers Grove, WI 54655 | 2020-02-03 |
| 1316587439 | Sixteenth Street Community Health Centers, Inc. | Clinic/Center | 1635 W National Ave, Milwaukee, WI 53204-1130 | 2020-01-07 |
| 1386283034 | Mainstreet Counseling | Clinic/Center | 1717 11th St, Monroe, WI 53566-1839 | 2019-12-29 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.