FAMILY SERVICES OF NORTHEAST WISCONSIN INC (NPI# 1275525925) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275525925 |
| Entity Type | Organization |
| Organization Name | FAMILY SERVICES OF NORTHEAST WISCONSIN INC |
| Other Organization Name | FAMILY SERVICES OF NEW |
| Practice Address |
1810 Appleton Rd Menasha WI 54952-1110 |
| Practice Telephone | 9207394226 |
| Practice Fax Number | 9207397639 |
| Mailing Telephone | 9207394226 |
| Mailing Fax Number | 9207397639 |
| Enumeration Date | 2005-08-18 |
| Last Update Date | 2009-06-04 |
| Authorized Official Name | MR. THOMAS E MARTIN (PRESIDENT / CEO) |
| Authorized Official Telephone | 9204366800 |
| Authorized Official Credential | LCSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
1333 | WI | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 42222600 | 05 |
| Other Name | Type Code |
|---|---|
| Family Services of NEW | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467453167 | Family Services of Northeast Wisconsin Inc | Clinic/Center | 300 Crooks St, Green Bay, WI 54301-4527 | 2005-08-03 |
| Street Address |
1810 APPLETON RD |
| City | MENASHA |
| State | WI |
| Zip Code | 54952-1110 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558846220 | Kahli J Nelson | Social Worker | 1810 Appleton Rd, Menasha, WI 54952-1110 | 2018-09-28 |
| 1588141360 | Brandon Lee Franzke | Counselor | 1810 Appleton Rd, Menasha, WI 54952-1164 | 2018-07-24 |
| 1912422155 | Rebecca Snell | Counselor | 1810 Appleton Rd, Menasha, WI 54952 | 2017-08-09 |
| 1134586779 | James K Dercks | Counselor | 1810 Appleton Rd, Menasha, WI 54952-1110 | 2016-01-27 |
| 1063889996 | Kathryn Eileen Keefe-neilson | Counselor | 1810 Appleton Rd, Menasha, WI 54952-1110 | 2015-08-26 |
| 1588960199 | Kathi Danke | Counselor | 1810 Appleton Rd, Menasha, WI 54952-1110 | 2011-01-28 |
| 1053388983 | Willard J Secor Jr. | Social Worker | 1810 Appleton Rd, Menasha, WI 54952-1110 | 2006-02-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275776239 | Sharon Louise Crowe | Dental Hygienist | 1814 North Appleton Road, Menasha, WI 54952 | 2009-04-07 |
| 1003056110 | Nicole Marie Guyette | Dental Hygienist | 814 N. Appleton Road, Menasha, WI 54952 | 2009-03-02 |
| 1760627624 | Jan Charles Sarnecki | Orthopaedic Surgery | 1814 N. Appleton Road, Menasha, WI 54952 | 2008-12-08 |
| 1588828297 | Lesley R Lathrop | Registered Nurse | 1764 Oakridge Court, Menasha, WI 54952 | 2008-07-11 |
| 1699965137 | Lisa Randerson | Counselor | 1427c Province Terrace, Menasha, WI 54952 | 2007-07-31 |
| 1689748675 | Lisa Lynn Lang Riegel | Dentist | 1155 Wittman Drive, Menasha, WI 54952 | 2006-11-20 |
| 1164596144 | Robert Charles Lang | Dentist | 1155 Wittmann Drive, Menasha, WI 54952 | 2006-11-20 |
| 1366527947 | Karen Patricia Schmidt | Case Manager/Care Coordinator | 1810 Appleton Road, Menasha, WI 54952 | 2006-10-25 |
| 1376647388 | Goodwill Industries of North Central Wi | Counselor | 1800 Appleton Road, Menasha, WI 54952 | 2006-09-11 |
| 1386135614 | Leslie J Steckbauer | Counselor | 1095 Midway Rd, Menasha, WI 54952 | 2018-05-22 |
| Find all providers in zip 54952 | ||||
| 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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|---|---|---|---|---|
| 1851954010 | Nuwave Counseling LLC | Clinic/Center | 1477 Kenwood Dr Ste 104, Menasha, WI 54952-1160 | 2019-04-15 |
| 1538175195 | Samaritan Counseling Center of The Fox Valley, Inc. | Clinic/Center | 1478 Kenwood Dr, Suite 1, Menasha, WI 54952 | 2006-08-01 |
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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 |
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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.