RACINE PSYCHOLOGICAL SERVICES, INC. (NPI# 1275586323) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275586323 |
| Entity Type | Organization |
| Organization Name | RACINE PSYCHOLOGICAL SERVICES, INC. |
| Practice Address |
840 Lake Ave Suite 101 Racine WI 53403-1566 |
| Practice Telephone | 2626348688 |
| Practice Fax Number | 2626347547 |
| Mailing Telephone | 2626348688 |
| Mailing Fax Number | 2626347547 |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2008-04-20 |
| Authorized Official Name | MARY JANE WHITMORE (DIRECTOR) |
| Authorized Official Telephone | 2626348688 |
| Authorized Official Credential | LCSW, CSAC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
2220 | WI | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 42216900 | 05 |
| Street Address |
840 LAKE AVE SUITE 101 |
| City | RACINE |
| State | WI |
| Zip Code | 53403-1566 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013166891 | Sammy Joe Rangel | Counselor | 840 Lake Ave, 101, Racine, WI 53403-1566 | 2008-09-16 |
| 1619148970 | Regina Marlene Hadley | Counselor | 840 Lake Ave, 101, Racine, WI 53403-1566 | 2008-03-14 |
| 1225168891 | Jean Marie Pruscha | Counselor | 840 Lake Ave, Suite 101, Racine, WI 53403-1566 | 2007-03-06 |
| 1316021405 | D Martin Hayden | Psychologist | 840 Lake Ave, Racine, Racine, WI 53403-1566 | 2006-10-25 |
| 1558305409 | Mariah Hewitt | Psychologist | 840 Lake Ave, Ste 101, Racine, WI 53403-1566 | 2006-06-15 |
| 1710925151 | Paul Wilhelm Voelkel | Psychologist | 840 Lake Ave, Suite 101, Racine, WI 53403-1566 | 2006-06-04 |
| 1134175334 | Mary Jane Whitmore | Counselor | 840 Lake Ave, Suite 101, Racine, WI 53403-1566 | 2006-05-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124676259 | Quality Care LLC | Clinic/Center | 2051 Mead St, Racine, WI 53403 | 2019-09-02 |
| 1073999355 | Wisconsin Lutheran Child & Family Service, Inc. | Social Worker | 6150 Taylor Avenue, Racine, WI 53403 | 2015-08-10 |
| 1457780496 | Pheynell Branch | Counselor | 1650 Wasington Ave, Racine, WI 53403 | 2013-11-08 |
| 1811278054 | Michelle Gloria Parisot | Psychologist | 1320 Wisconsin Ave., Racine, WI 53403 | 2011-09-01 |
| 1720372022 | Katie Hagen | Social Worker | 1717 Taylor Avenue, Racine, WI 53403 | 2011-06-03 |
| 1043431570 | Rita S Harris | Physical Therapy Assistant | Lakeshore Manor 1320 Wisconsin Avenue, Racine, WI 53403 | 2007-05-01 |
| 1336281336 | Linda J Hockensmith | Occupational Therapist | 4214 Sheridan Road, Racine, WI 53403 | 2007-02-13 |
| 1851447387 | Richard John Kemper | Dentist | 1509 Washington Ave, Racine, WI 53403 | 2007-01-26 |
| 1689760332 | Lester Leslie Higgenbottom | Counselor | 1820 Arlington Ave, Racine, WI 53403 | 2006-10-04 |
| 1114942315 | Access Medical Center, LLC | Clinic/Center | 4216 Old Green Bay Rd, Racine, WI 53403 | 2006-07-12 |
| Find all providers in zip 53403 | ||||
| Taxonomy Code | 261QM0850X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |
| Notes: [7/1/2003: new] |
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|---|---|---|---|---|
| 1730748724 | Molly Lubin Md LLC | Clinic/Center | 16 N Carroll St Ste 450-c, Madison, WI 53703-2716 | 2019-06-12 |
| 1346702826 | Kris Huenink Counseling Services LLC | Clinic/Center | 501 N 8th St Ste 110, Sheboygan, WI 53081-4461 | 2019-04-03 |
| 1720550981 | Purple Lotus Counseling LLC | Clinic/Center | 516 E Wisconsin Ave Ste C, Appleton, WI 54911-4864 | 2018-12-27 |
| 1831677079 | Creative Calm Counseling LLC | Clinic/Center | 2380 State Road 44 Ste G, Oshkosh, WI 54904-6440 | 2018-07-31 |
| 1407370398 | Tombolo, LLC | Clinic/Center | 12545 W. Burleigh Rd., Suite 10, Brookfield, WI 53005 | 2017-08-01 |
| 1730530239 | Home Away From Home Living Services LLC | Clinic/Center | 8127 W Herbert Ave, Milwaukee, WI 53218-3632 | 2016-06-26 |
| 1891149928 | Tcg Holdings 14, LLC | Clinic/Center | 127 N Franklin St Ste 206, Port Washington, WI 53074-1948 | 2016-04-14 |
| 1427410992 | Shelley Boehm Mattia Md,adult Psychiatry, LLC | Clinic/Center | 428 Doty St, Green Bay, WI 54301-4509 | 2016-03-24 |
| 1982002242 | Family & Childrens Center | Clinic/Center | 920 W Wisconsin St, Sparta, WI 54656-4217 | 2014-12-18 |
| 1154675924 | Northshore Clinic LLC | Clinic/Center | 805 N 6th St, Sheboygan, WI 53081-4113 | 2012-11-01 |
| Find all providers with the same taxonomy | ||||
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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.