FOND DU LAC CO DCP CCS PROGRAM (NPI# 1255454047) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255454047 |
| Entity Type | Organization |
| Organization Name | FOND DU LAC CO DCP CCS PROGRAM |
| Practice Address |
459 E 1st St Fond Du Lac WI 54935-4505 |
| Practice Telephone | 9209293500 |
| Mailing Telephone | 9209293500 |
| Enumeration Date | 2007-04-09 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MARY ELLEN MCMEEN (DIRECTOR-MENTAL HEALTH & AODA) |
| Authorized Official Telephone | 9209293500 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 41763000 | 05 |
| Street Address |
459 E 1ST ST |
| City | FOND DU LAC |
| State | WI |
| Zip Code | 54935-4505 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659358323 | Fond Du Lac County | Skilled Nursing Facility | 459 E 1st St, Fond Du Lac, WI 54935-4505 | 2005-12-23 |
| 1851999114 | Megan Moore | Physical Therapist | 459 E 1st St, Fond Du Lac, WI 54935-4505 | 2020-10-09 |
| 1215550397 | Kayla Pieper | Case Manager/Care Coordinator | 459 E 1st St, Fond Du Lac, WI 54935-4505 | 2020-05-22 |
| 1942832811 | Matthew Olig | Occupational Therapist | 459 E 1st St, Fond Du Lac, WI 54935-4505 | 2020-02-10 |
| 1609408681 | Emma K Felckowski | Occupational Therapy Assistant | 459 E 1st St, Fond Du Lac, WI 54935-4505 | 2020-02-07 |
| 1811533607 | Brittany Stark | Counselor | 459 E 1st St, Fond Du Lac, WI 54935-4505 | 2019-11-27 |
| 1629613591 | Angela Brahm | Case Manager/Care Coordinator | 459 E 1st St, Fond Du Lac, WI 54935-4505 | 2019-11-14 |
| 1336790500 | Lynn Propson | Social Worker | 459 E 1st St, Fond Du Lac, WI 54935-4505 | 2019-09-27 |
| 1376199208 | Jaclyn Rose Hanson | Physical Therapy Assistant | 459 E 1st St, Fond Du Lac, WI 54935-4505 | 2019-08-15 |
| 1972165017 | Joseph Babiak | Counselor | 459 E 1st St, Fond Du Lac, WI 54935-4505 | 2019-06-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609482249 | Keziah Sherri Love | Counselor | W390 Wi-23, Fond Du Lac, WI 54935 | 2020-09-18 |
| 1891341988 | Cynthia Louise Singleton | Nurse Practitioner | 16 E 13th St., Fond Du Lac, WI 54935 | 2019-08-14 |
| 1083183297 | Elena Alexandra Giese | Nurse Practitioner | 430 E. Division St, Fond Du Lac, WI 54935 | 2018-11-16 |
| 1669963740 | Elizabeth Anne Machi | Student in an Organized Health Care Education/Training Program | 885 Western Ave Ste 300, Fond Du Lac, WI 54935 | 2018-05-23 |
| 1184150021 | Jordan Moehn | Specialist/Technologist | 633 Prairie Pkwy, Fond Du Lac, WI 54935 | 2017-05-11 |
| 1467856336 | Chuentao Ho | Specialist/Technologist | 45 South National Ave., Fond Du Lac, WI 54935 | 2014-10-21 |
| 1437587961 | Paula Seeley | Nurse Practitioner | 63 West Pioneer Rd, Fond Du Lac, WI 54935 | 2013-10-18 |
| 1144516030 | Bonnie Kay Mallon | Registered Nurse | 118 E 9th St, Fond Du Lac, WI 54935 | 2011-06-20 |
| 1770885600 | Holly Shepard | Counselor | 23 W Scott St., Fond Du Lac, WI 54935 | 2010-11-29 |
| 1437479110 | Ruth Marie Bohn | Occupational Therapy Assistant | 244 North Macy Street, Fond Du Lac, WI 54935 | 2010-06-04 |
| Find all providers in zip 54935 | ||||
| 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 |
|---|---|---|---|---|
| 1558695304 | Lutheran Social Services of Upper Michigan | Community/Behavioral Health | 131 S,. Main Street, Fond Du Lac, WI 54935 | 2009-09-28 |
| 1982877411 | Arc Community Services, Inc. | Community/Behavioral Health | 17 Forest Ave, Fond Du Lac, WI 54935-4155 | 2008-04-04 |
| 1346620952 | Premier Care of Wisconsin, LLC. | Community/Behavioral Health | 23 W Scott St, Fond Du Lac, WI 54935-2342 | 2015-06-09 |
| 1548603657 | Minerva Counseling Center | Community/Behavioral Health | 493 S Main St, Fond Du Lac, WI 54935-5736 | 2013-04-09 |
| 1558537654 | Fond Du Lac County Dcp Crisis (non-billable) | Community/Behavioral Health | 459 E 1st St, Fond Du Lac, WI 54935-4505 | 2008-05-08 |
| 1679746630 | Fond Du Lac County Dcp Ccs Program | Community/Behavioral Health | 459 E 1st St, Fond Du Lac, WI 54935-4505 | 2008-04-10 |
| 1235252024 | Fond Du Lac County | Community/Behavioral Health | 459 E 1st St, Fond Du Lac, WI 54935-4505 | 2007-04-09 |
| 1306969191 | Fond Du Lac County Dcp Crisis Intervention | Community/Behavioral Health | 459 E 1st St, Fond Du Lac, WI 54935-4505 | 2007-04-09 |
| 1053458935 | Fond Du Lac County | Community/Behavioral Health | 459 E 1st St, Fond Du Lac, WI 54935-4505 | 2007-01-31 |
| 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 |
| Find all providers with the same taxonomy | ||||
| City | FOND DU LAC |
| Zip Code | 54935 |
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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.