LAKE MONONA PSYCHOTHERAPY & RECOVERY CENTER (NPI# 1265512586) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265512586 |
| Entity Type | Organization |
| Organization Name | LAKE MONONA PSYCHOTHERAPY & RECOVERY CENTER |
| Practice Address |
900 John Nolen Dr Suite 100 Madison WI 53713-1465 |
| Practice Telephone | 6082565030 |
| Practice Fax Number | 6082565038 |
| Mailing Telephone | 6082565030 |
| Mailing Fax Number | 6082565038 |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | BRIDGET J CREMIN (OFFICE MANAGER) |
| Authorized Official Telephone | 6082565030 |
| Authorized Official Credential | MSW, RADCI |
| 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 | 42147700 | 05 |
| Street Address |
900 JOHN NOLEN DR SUITE 100 |
| City | MADISON |
| State | WI |
| Zip Code | 53713-1465 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407139447 | Aleisha M Anderson | Acupuncturist | 900 John Nolen Dr, Suite 100, Madison, WI 53713-1465 | 2011-09-26 |
| 1487855722 | Beverly Hills | Counselor | 900 John Nolen Dr, Suite 100, Madison, WI 53713-1465 | 2007-05-31 |
| 1548341449 | Claudia Greco | Counselor | 900 John Nolen Dr, Suite 100, Madison, WI 53713-1465 | 2006-10-18 |
| 1720169634 | Sally J Stevens | Counselor | 900 John Nolen Dr, Suite 100, Madison, WI 53713-1465 | 2006-10-18 |
| 1780765685 | Ellanora Ward | Psychologist | 900 John Nolen Dr, Suite 100, Madison, WI 53713-1465 | 2006-10-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508406760 | Diana Kay Woodruff | Registered Nurse | Madison West Comprehensive Treatment Center, 151 E. Badger Rd. Suite A, Madison, WI 53713 | 2020-01-15 |
| 1568008886 | Avery Reven Kansteiner | Counselor | 105 Ski Court, Madison, WI 53713 | 2019-11-21 |
| 1518501329 | Erica D Anderson | Counselor | 1125 W Badger Rd Apt 6, Madison, WI 53713 | 2019-11-05 |
| 1942799739 | Emily Natera | Counselor | 128 E. Olin Ave., Ste. 100, Madison, WI 53713 | 2018-05-07 |
| 1295255644 | Renee Denise Wilberg | Counselor | 122 E. Olin Avenue, Madison, WI 53713 | 2017-06-26 |
| 1548793060 | Racquel Williams-kroll | Registered Nurse | 151 East Badger Road Ste A, Madison, WI 53713 | 2017-04-11 |
| 1124570841 | Shirley Norman-johnson | Licensed Practical Nurse | 115 East Badger Rd, Suite A, Madison, WI 53713 | 2016-10-28 |
| 1629525613 | Katherine Simons Melde | Nurse Practitioner | 2222 S Park St Ste 210, Madison, WI 53713 | 2016-09-07 |
| 1013301779 | Bio-medical Applications of Wisconsin, Inc. | Clinic/Center | 2840 Index Rd., Madison, WI 53713 | 2015-03-20 |
| 1902147721 | Jill Zimmerman | Occupational Therapy Assistant | 2801 Coho Street, Suite 300, Madison, WI 53713 | 2013-03-04 |
| Find all providers in zip 53713 | ||||
| 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 |
|---|---|---|---|---|
| 1871141366 | Boone Memorial Hospital, Inc. | Community/Behavioral Health | 467 Main St Ste 4, Madison, WV 25130-2200 | 2019-08-28 |
| 1154838399 | Leslie Smith Lpc LLC | Community/Behavioral Health | 650 Sun Temple Dr, Madison, AL 35758-8621 | 2018-01-09 |
| 1497268817 | Imagine A Childs Capacity LLC | Community/Behavioral Health | 128 E Olin Ave Ste 201, Madison, WI 53713-1467 | 2017-11-07 |
| 1316464191 | Shore Wellness Ct | Community/Behavioral Health | 85b Wall St, Madison, CT 06443-3121 | 2017-08-23 |
| 1407302532 | Aba Steps LLC | Community/Behavioral Health | 3 Niles Ave, Madison, NJ 07940-2310 | 2016-08-29 |
| 1245786680 | Michelle Ayres, Ms, Lmft | Community/Behavioral Health | 111 S 1st St # 103, Madison, WI 53704-5244 | 2016-08-26 |
| 1124471412 | Lifeworks Counseling | Community/Behavioral Health | 940 Ebenezer Blvd., Madison, MS 39110 | 2016-07-21 |
| 1184078628 | Bridgeway Counseling | Community/Behavioral Health | 540 Hughes Rd Ste 3, Madison, AL 35758-8959 | 2016-04-21 |
| 1588022206 | Moore Counseling Services | Community/Behavioral Health | 808 Nw 3rd St, Madison, SD 57042-2518 | 2016-02-09 |
| 1073988051 | Killebrew Psychological Services, LLC | Community/Behavioral Health | 133 Berry Ln, Madison, MS 39110-8616 | 2015-12-02 |
| Find all providers in MADISON | ||||
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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.