TRIVIUM LLC (NPI# 1265450753) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1265450753 |
Entity Type | Organization |
Organization Name | TRIVIUM LLC |
Other Organization Name | CROSSROADS COUNSELING CENTER |
Practice Address |
17 S. River St. Suite 254 Janesville WI 53548-3863 |
Mailing Address |
17 S. River St Suite 254 Janesville WI 53548-3863 |
Practice Telephone | 6087555260 |
Practice Fax Number | 6087555267 |
Mailing Telephone | 6087555260 |
Mailing Fax Number | 6087555267 |
Enumeration Date | 2006-07-17 |
Last Update Date | 2014-12-11 |
Authorized Official Name | MR. TIMOTHY F. PERRY (ADMINISTRATOR) |
Authorized Official Telephone | 6087555260 |
Authorized Official Credential | MSSW, LCSW, LMFT |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities | ||
N | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
1265 | WI | Ambulatory Health Care Facilities |
N | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
2868 | WI | Ambulatory Health Care Facilities |
Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
1265 | WI | Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
WI | 42105900 | 05 |
Other Name | Type Code |
---|---|
Crossroads Counseling Center | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1427463066 | Trivium LLC | Clinic/Center | 778 Lois Dr, Sun Prairie, WI 53590-1100 | 2014-06-23 |
1114342441 | Trivium LLC | Clinic/Center | 17 S River St, Janesville, WI 53548-3860 | 2014-02-24 |
Entity Type | Entity Name | Entity Address |
---|---|---|
North Carolina Corporations | Trivium LLC | 2301 Stantonsburg Road, Wilson, NC 27893 |
Street Address |
17 S. RIVER ST. SUITE 254 |
City | JANESVILLE |
State | WI |
Zip Code | 53548-3863 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1760833099 | Samantha J Ball | Counselor | 17 S. River St., 254, Janesville, WI 53548-3863 | 2016-06-28 |
1649620725 | Prairie L Degraw | Counselor | 17 S. River St., Suite 254, Janesville, WI 53548-3863 | 2016-06-20 |
1902281033 | Douglas H Fleischfresser | Counselor | 17 S. River St., Suite 254, Janesville, WI 53548-3863 | 2015-07-30 |
1093113458 | Kendra J Bechtol | Social Worker | 17 S. River St., Suite 254, Janesville, WI 53548-3863 | 2014-12-16 |
1659779148 | Rena Ann Cross | Counselor | 17 S. River St., Suite 254, Janesville, WI 53548-3863 | 2014-12-15 |
1609202035 | Guy W Shilts IIi | Counselor | 17 S. River St., Suite 254, Janesville, WI 53548-3863 | 2013-09-17 |
1841524485 | Rachel Ann Hansen | Psychologist | 17 S. River St., Suite 254, Janesville, WI 53548 | 2009-09-30 |
1992956957 | David Kohlmeyer | Social Worker | 17 S. River St., Suite 254, Janesville, WI 53548 | 2008-10-08 |
1790932671 | Kelly Nicole Mckinnon | Counselor | 17 S. River St., Suite 254, Janesville, WI 53548 | 2008-08-22 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1578846010 | Patricia Ann Sheets | Licensed Vocational Nurse | 316 N. Terrace St., Janbesville, WI 53548 | 2011-09-21 |
1760658983 | Kristy Kay Prentice Kerl | Dental Hygienist | 121 Jonathon Dr, Janesville, WI 53548 | 2008-05-07 |
1316005978 | City of Janesville | Emergency Medical Technician, Paramedic | 18 N Jackson St, Janesville, WI 53548 | 2006-12-05 |
1558464115 | Sarah Louise Hessenauer | Social Worker | 17 S. River St, Suite 254, Janesville, WI 53548 | 2006-09-07 |
1073548327 | Mary Katherine Cefalu | Registered Nurse | 17 S. River, Suite 254, Janesville, WI 53548 | 2006-07-12 |
1699707950 | Gary Lavern Jones | Counselor | 175 River, Suite 254, Janesville, WI 53548 | 2006-07-07 |
1295767424 | Michael Stuart Kaye | Clinical Neuropsychologist | 17 S River St Ste 254, Janesville, WI 53548 | 2006-07-07 |
1205864055 | Amy Laurie Roy | Counselor | 17 S River Suite 254, Janesville, WI 53548 | 2006-06-29 |
1518903566 | Leota I Larson | Psychologist | 17 S River, Suite 254, Janesville, WI 53548 | 2006-06-20 |
1760950414 | North Star Chiropractic LLC | Chiropractor | 21 S Jackson St, Ste 160, Janesville, WI 53548 | 2018-11-10 |
Find all providers in zip 53548 |
Taxonomy Code | 261QM0801X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Mental Health (Including Community Mental Health Center) |
Definition to come... |
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1316297492 | Alcocare Inc. | Clinic/Center | 314 W Court St, Janesville, WI 53548-3846 | 2012-09-15 |
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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 |
City | JANESVILLE |
Zip Code | 53548 |
Please comment or provide details below to improve the information on TRIVIUM LLC.
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.