TELLURIAN, INC. (NPI# 1235302480) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235302480 |
| Entity Type | Organization |
| Organization Name | TELLURIAN, INC. |
| Other Organization Name | TELLURIAN UCAN INC. |
| Practice Address |
300 Femrite Dr Monona WI 53716-3716 |
| Practice Telephone | 6082227311 |
| Practice Fax Number | 6082225904 |
| Mailing Telephone | 6082227311 |
| Mailing Fax Number | 6082225904 |
| Enumeration Date | 2008-04-09 |
| Last Update Date | 2019-05-06 |
| Authorized Official Name | KELLY E CROOKS (QUALITY ASSURANCE MANAGER) |
| Authorized Official Telephone | 6086632120 |
| Authorized Official Credential | MSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | 774 | WI | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 39394400 | 05 |
| Other Name | Type Code |
|---|---|
| Tellurian Outpatient Clinic | Other Name - Individual/Organization |
| Tellurian UCAN Inc. | Former Legal Business Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043487697 | Tellurian, Inc. | Community/Behavioral Health | 2914 Industrial Dr, Madison, WI 53713-4047 | 2008-05-13 |
| 1164432118 | Tellurian, Inc. | Psychiatry & Neurology | 1053 Williamson St, Madison, WI 53703-3525 | 2006-08-09 |
| 1740213776 | Tellurian, Inc. | Community/Behavioral Health | 300 Femrite Dr, Monona, WI 53716-3716 | 2006-07-10 |
| 1104279330 | Tellurian, Inc. | Community/Behavioral Health | 414 Broadway St, Suite 101, Baraboo, WI 53913-2488 | 2016-07-22 |
| 1013261486 | Tellurian, Inc. | Substance Abuse Rehabilitation Facility | 2914 Industrial Dr, Madison, WI 53713-4047 | 2012-11-06 |
| 1609129410 | Tellurian, Inc. | Community Based Residential Treatment Facility, Mental Illness | 300 Femrite Dr, Monona, WI 53716-3716 | 2012-10-17 |
| 1437401338 | Tellurian, Inc. | Community Based Residential Treatment Facility, Mental Illness | 4647 Mormon Coulee Rd, La Crosse, WI 54601-8225 | 2012-10-03 |
| 1558638494 | Tellurian, Inc. | Substance Abuse Rehabilitation Facility | 300 Femrite Dr, Monona, WI 53716-3716 | 2011-11-21 |
| Street Address |
300 FEMRITE DR |
| City | MONONA |
| State | WI |
| Zip Code | 53716-3716 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740213776 | Tellurian, Inc. | Community/Behavioral Health | 300 Femrite Dr, Monona, WI 53716-3716 | 2006-07-10 |
| 1801493994 | Caitlin Mary Clifford | Counselor | 300 Femrite Dr, Monona, WI 53716-3798 | 2020-10-02 |
| 1831756428 | Rebecca J Kienbaum | Counselor | 300 Femrite Dr, Monona, WI 53716-3716 | 2019-05-20 |
| 1598223455 | Heather E Schneider | Counselor | 300 Femrite Dr, Monona, WI 53716-3798 | 2019-03-08 |
| 1063998508 | Lindsey Resendiz | Counselor | 300 Femrite Dr, Monona, WI 53716-3798 | 2018-07-18 |
| 1992202360 | Jennifer R Klawitter | Counselor | 300 Femrite Dr, Monona, WI 53716-3798 | 2018-04-11 |
| 1164929253 | James E Kilgore | Counselor | 300 Femrite Dr, Monona, WI 53716-3716 | 2018-04-06 |
| 1861899718 | Kristina Modaff | Counselor | 300 Femrite Dr, Monona, WI 53716-3716 | 2014-11-20 |
| 1558766949 | Jack Gieche | Counselor | 300 Femrite Dr, Monona, WI 53716 | 2014-10-28 |
| 1710314281 | Casey Elizabeth Simons | Counselor | 300 Femrite Dr, Monona, WI 53716-3716 | 2013-09-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730738873 | Richard Onyait | Technician | 1103 Birch Haven Cir, Monona, WI 53716 | 2019-09-11 |
| 1962950428 | Paige Corliss | Pharmacist | 1821 S. Stoughton Road, Madison, WI 53716 | 2016-09-13 |
| 1760840946 | Stacey Palermo | Marriage & Family Therapist | 303 Frost Woods Rd, Monona, WI 53716 | 2016-02-03 |
| 1326414442 | Diane Marie Kelley | Nurse Practitioner | 300 Femrite Drive, Monona, WI 53716 | 2015-08-12 |
| 1942692520 | Kelsey Lynn Markham | Counselor | 5900 Monona Drive, Suite 100, Monona, WI 53716 | 2015-02-19 |
| 1225452733 | Nicole Moscinski | Marriage & Family Therapist | 6117 Monona Dr Ste 1b, Monona, WI 53716 | 2014-02-05 |
| 1013345644 | Emma Amanda Rose | Physician Assistant | 521 Bowman Ave., Madison, WI 53716 | 2013-10-16 |
| 1407154271 | Jennifer Orshak | Registered Nurse | 5410 Forge Drive, Madison, WI 53716 | 2011-03-03 |
| 1982906525 | Jennifer Chun | Dentist | 100 River Pl Ste 110, Monona, WI 53716 | 2010-12-02 |
| 1609041987 | Jennifer A Britain | Physical Therapist | 1821 South Stoughton Rd, Madison, WI 53716 | 2008-04-28 |
| Find all providers in zip 53716 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487192928 | Forward Counseling & Consultation | Community/Behavioral Health | 6320 Monona Dr Ste 415, Monona, WI 53716-3975 | 2017-02-04 |
| 1740213776 | Tellurian, Inc. | Community/Behavioral Health | 300 Femrite Dr, Monona, WI 53716-3716 | 2006-07-10 |
| 1265946990 | New Growth Mental Health Counseling, LLC | Community/Behavioral Health | 5900 Monona Dr Ste 312, Monona, WI 53716-3561 | 2017-11-16 |
| 1972824571 | Healing Hearts Family Counseling Center, LLC | Community/Behavioral Health | 2829 Royal Ave, Monona, WI 53713-1535 | 2010-06-17 |
| 1679755987 | Lake City Counseling, LLC | Community/Behavioral Health | 2829 Royal Ave, Monona, WI 53713-1541 | 2007-11-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558968990 | Zoran Jovicic | Community/Behavioral Health | 3239 S 58th St Unit 104, Milwaukee, WI 53219-4365 | 2020-10-08 |
| 1437776457 | Milkweed Connections LLC | Community/Behavioral Health | 1700 Tainter St Ste D, Menomonie, WI 54751-1358 | 2020-06-26 |
| 1477178473 | Grace Counseling & Family Services S.c | Community/Behavioral Health | 121 S Adams St, New Lisbon, WI 53950-1205 | 2020-06-15 |
| 1740804491 | Strides Equestrian Therapeutic Center LLC | Community/Behavioral Health | W6769 Colby Factory Rd, Greenwood, WI 54437-9010 | 2020-05-28 |
| 1841831153 | Sheboygan County Halfway House | Community/Behavioral Health | 503 Ontario Ave, Sheboygan, WI 53081-4151 | 2019-10-08 |
| 1780234955 | Spirited Psychological Services LLC | Community/Behavioral Health | 376 Violet Cir, Grantsburg, WI 54840-8564 | 2019-09-18 |
| 1548816580 | Latara Williams | Community/Behavioral Health | 2447 N 50th St, Milwaukee, WI 53210-2815 | 2019-08-15 |
| 1942856091 | Kennedy's Circle of Wellness LLC | Community/Behavioral Health | 3614 W North Ave, Milwaukee, WI 53208-1416 | 2019-08-14 |
| 1104386101 | Counseling Center | Community/Behavioral Health | 601 N 5th St, Sheboygan, WI 53081-4624 | 2019-03-25 |
| 1205391828 | Jerome Pitchford | Community/Behavioral Health | 1220 W Atkinson Ave, Milwaukee, WI 53206-3024 | 2019-02-07 |
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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.