TED D IZYDOR (NPI# 1275501140) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275501140 |
| Entity Type | Individual |
| Full Name | TED D IZYDOR |
| Credential | LPC |
| Practice Address |
128 E Olin Ave Suite 100 Madison WI 53713-1467 |
| Practice Telephone | 6082521320 |
| Practice Fax Number | 6082521333 |
| Mailing Telephone | 6082521320 |
| Mailing Fax Number | 6082521333 |
| Enumeration Date | 2006-03-08 |
| Last Update Date | 2011-10-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
14034-132 | WI | Behavioral Health & Social Service Providers |
| Y | 101YP2500X |
Counselor Specialization: Professional |
2878 | WI | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 1275501140 | 05 |
| Street Address |
128 E OLIN AVE SUITE 100 |
| City | MADISON |
| State | WI |
| Zip Code | 53713-1467 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912377854 | Simone Frame | Speech-Language Pathologist | 128 E Olin Ave, 100, Madison, WI 53713-1467 | 2015-10-05 |
| 1487041828 | Ashley Inez Ball | Marriage & Family Therapist | 128 E Olin Ave, Madison, WI 53713-1467 | 2015-04-23 |
| 1528478286 | Thomas Carroll | Counselor | 128 E Olin Ave, Madison, WI 53713-1467 | 2014-05-04 |
| 1558787770 | Renee Sahagian | Counselor | 128 E Olin Ave, Suite 100, Madison, WI 53713-1467 | 2014-03-12 |
| 1831526219 | Theresa Joy Ditlow | Counselor | 128 E Olin Ave, Madison, WI 53713 | 2013-10-01 |
| 1548505498 | Sarah A Shatz | Social Worker | 128 E Olin Ave, Suite 100, Madison, WI 53713-1467 | 2012-12-04 |
| 1669717500 | Audra J Sulewski | Social Worker | 128 E Olin Ave, Suite 100, Madison, WI 53713-1467 | 2012-12-04 |
| 1982949210 | Jessica E Dingee | Social Worker | 128 E Olin Ave, Suite 100, Madison, WI 53713-1467 | 2012-11-27 |
| 1790061422 | Christin J Gibbons | Marriage & Family Therapist | 128 E Olin Ave, Suite 100, Madison, WI 53713-1467 | 2011-10-26 |
| 1578846861 | Caroline J Young | Counselor | 128 E Olin Ave, Suite 100, Madison, WI 53713-1467 | 2011-09-22 |
| Find all providers in the same location | ||||
| 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 | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619578770 | Sunshine Holstein | Counselor | 467 Main St Fl 4, Madison, WV 25130-2200 | 2020-11-05 |
| 1619589538 | Pamela Peoples | Counselor | 1888 Main St Ste C-189, Madison, MS 39110-6337 | 2020-08-21 |
| 1487278404 | Gillian Vandien | Counselor | 2701 International Ln Ste 205, Madison, WI 53704-3126 | 2020-06-05 |
| 1134740210 | Amy C Nicholson | Counselor | 720 Hill St Ste 230, Madison, WI 53705-3539 | 2020-04-30 |
| 1902435308 | Jeffrey Joseph Bopp | Counselor | 518 Diving Hawk Trl, Madison, WI 53713-3380 | 2020-04-07 |
| 1881222313 | Christopher Gabriel Krell | Counselor | 133 Se Macon St, Madison, FL 32340-2986 | 2020-03-30 |
| 1174153381 | Kristine Fernerud | Counselor | 77 Legend Hill Rd, Madison, CT 06443-1877 | 2020-01-16 |
| 1568008886 | Avery Reven Kansteiner | Counselor | 105 Ski Court, Madison, WI 53713 | 2019-11-21 |
| 1124661996 | Lillian A Carroll | Counselor | 502 Pflaum Rd, Madison, WI 53716-2163 | 2019-10-23 |
| 1700436466 | David R. Gosling | Counselor | 702 South High Point Road #209, Madison, WI 53719 | 2019-09-16 |
| 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.