COUNTY OF SHAWANO (NPI# 1558528729) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1558528729 |
Entity Type | Organization |
Organization Name | COUNTY OF SHAWANO |
Other Organization Name | SHAWANO COUNTY DEPT OF HUMAN SERVICES -LAKELAND CENTER CSP SVCS |
Practice Address |
504 Lakeland Rd Shawano WI 54166 |
Practice Telephone | 7155264700 |
Practice Fax Number | 7155265542 |
Mailing Telephone | 7155264700 |
Mailing Fax Number | 7155265542 |
Enumeration Date | 2008-05-16 |
Last Update Date | 2015-01-23 |
Authorized Official Name | MR. RICHARD KANE (DIRECTOR) |
Authorized Official Telephone | 7155264700 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 251S00000X | Community/Behavioral Health | 1831 | WI | Agencies |
Y | 251S00000X | Community/Behavioral Health | 2242 | WI | Agencies |
State | Issuer | Identifier | Type Code |
---|---|---|---|
WI | 43425800 | 05 |
Other Name | Type Code |
---|---|
SHAWANO COUNTY DEPT OF HUMAN SERVICES -LAKELAND CENTER CSP SVCS | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1174716385 | County of Shawano | Clinic/Center | 311 N Main St Rm 7, Shawano, WI 54166-2145 | 2007-08-21 |
1720088495 | County of Shawano | Intermediate Care Facility, Mentally Retarded | N4231 State Highway 22, Shawano, WI 54166-6130 | 2005-07-26 |
1831454370 | County of Shawano | Home Health | 504 Lakeland Road, Shawano, WI 54166-3836 | 2012-07-11 |
1407014020 | County of Shawano | Community/Behavioral Health | 504 Lakeland Rd, Shawano, WI 54166-3836 | 2008-05-30 |
1336307008 | County of Shawano | Community/Behavioral Health | 504 Lakeland Rd, Shawano, WI 54166-3836 | 2008-05-29 |
1750549432 | County of Shawano | Community/Behavioral Health | 504 Lakeland Rd, Shawano, WI 54166-3836 | 2008-05-29 |
1215195987 | County of Shawano | Community/Behavioral Health | 504 Lakeland Rd, Shawano, WI 54166-3836 | 2008-05-29 |
1497896641 | County of Shawano | Community/Behavioral Health | 504 Lakeland Rd, Shawano, WI 54166 | 2007-02-09 |
1124028519 | County of Shawano | Skilled Nursing Facility | N4231 State Highway 22, Shawano, WI 54166-6130 | 2005-07-28 |
Street Address |
504 LAKELAND RD |
City | SHAWANO |
State | WI |
Zip Code | 54166 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1992894224 | Joann W Liska | Counselor | 504 Lakeland Rd, Shawano, WI 54166-3836 | 2006-10-12 |
1376001636 | Gregory Nordwig | Registered Nurse | 504 Lakeland Rd, Shawano, WI 54166-3836 | 2019-03-06 |
1811495294 | Jenna Hammer | Counselor | 504 Lakeland Rd, Shawano, WI 54166-3836 | 2018-01-31 |
1326582305 | Christopher Kuhn | Counselor | 504 Lakeland Rd, Shawano, WI 54166-3836 | 2016-12-12 |
1659821981 | Shawano County Department of Human Services | Counselor | 504 Lakeland Rd, Shawano, WI 54166-3836 | 2016-10-11 |
1891180337 | Tracy Porath | Counselor | 504 Lakeland Rd, Shawano, WI 54166-3836 | 2015-04-01 |
1942695481 | Jeffrey Herman | Counselor | 504 Lakeland Rd, Shawano, WI 54166-3836 | 2015-04-01 |
1942607056 | Judy Laude | Social Worker | 504 Lakeland Rd, Shawano, WI 54166-3836 | 2014-12-04 |
1750798914 | Alicia Elliott | Counselor | 504 Lakeland Rd, Shawano, WI 54166-3836 | 2014-07-18 |
1558778324 | Julie Behnke | Counselor | 504 Lakeland Rd, Shawano, WI 54166-3836 | 2014-07-14 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1134641848 | Nicole Jeannine Klotzbuecher | Optometrist | 150 County Road B, Shawano, WI 54166 | 2017-07-13 |
1437605714 | Jennifer Marie Franke | Counselor | 504 Lakeland St, Shawano, WI 54166 | 2016-08-28 |
1699017913 | Benjamin D Schlais | Family Medicine | 100 County Hwy B, Shawano, WI 54166 | 2013-03-25 |
1154574366 | Luke T Johnson | Speech-Language Pathologist | N3684 River Road, Shawano, WI 54166 | 2008-10-31 |
1902054315 | Robert Joseph Bohr Jr. | Physical Therapy Assistant | N6590 Fox Lane, Shawano, WI 54166 | 2008-08-28 |
1790945863 | Patricia Rae Ainsworth | Physical Therapist | 1436 South Lincoln Street, Shawano, WI 54166 | 2008-06-12 |
1649491820 | Shawano-gresham School District | Local Education Agency (LEA) | 1050 South Union Street, Shawano, WI 54166 | 2007-05-02 |
1114043387 | Thomas G Peterson | Optometrist | 150a County Road B, Shawano, WI 54166 | 2007-03-21 |
1740343086 | John Milton Dovorany | Dentist | 1488 E Green Bay St, Shawano, WI 54166 | 2006-12-18 |
1265526305 | Charles E Lamarche | Counselor | 420 E Green Bay St, Ste 201, Shawano, WI 54166 | 2006-10-03 |
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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 |
---|---|---|---|---|
1073990420 | Bridge The Gap, Inc | Community/Behavioral Health | 1415 E Green Bay St, Suite 111, Shawano, WI 54166-3879 | 2015-05-05 |
1407014020 | County of Shawano | Community/Behavioral Health | 504 Lakeland Rd, Shawano, WI 54166-3836 | 2008-05-30 |
1336307008 | County of Shawano | Community/Behavioral Health | 504 Lakeland Rd, Shawano, WI 54166-3836 | 2008-05-29 |
1750549432 | County of Shawano | Community/Behavioral Health | 504 Lakeland Rd, Shawano, WI 54166-3836 | 2008-05-29 |
1215195987 | County of Shawano | Community/Behavioral Health | 504 Lakeland Rd, Shawano, WI 54166-3836 | 2008-05-29 |
1174781298 | King Psychological Services | Community/Behavioral Health | 1488 E Green Bay St, Shawano, WI 54166-2258 | 2008-05-27 |
1306003587 | Shawano County Department of Community Program | Community/Behavioral Health | 504 Lakeland Rd, Shawano, WI 54166-3836 | 2008-05-16 |
1497896641 | County of Shawano | Community/Behavioral Health | 504 Lakeland Rd, Shawano, WI 54166 | 2007-02-09 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1558968990 | Zoran Jovicic | Community/Behavioral Health | 3239 S 58th St Unit 104, Milwaukee, WI 53219-4365 | 2020-10-08 |
1437776457 | Milkweed Connections LLC | Community/Behavioral Health | 1700 Tainter St Ste D, Menomonie, WI 54751-1358 | 2020-06-26 |
1477178473 | Grace Counseling & Family Services S.c | Community/Behavioral Health | 121 S Adams St, New Lisbon, WI 53950-1205 | 2020-06-15 |
1740804491 | Strides Equestrian Therapeutic Center LLC | Community/Behavioral Health | W6769 Colby Factory Rd, Greenwood, WI 54437-9010 | 2020-05-28 |
1841831153 | Sheboygan County Halfway House | Community/Behavioral Health | 503 Ontario Ave, Sheboygan, WI 53081-4151 | 2019-10-08 |
1780234955 | Spirited Psychological Services LLC | Community/Behavioral Health | 376 Violet Cir, Grantsburg, WI 54840-8564 | 2019-09-18 |
1548816580 | Latara Williams | Community/Behavioral Health | 2447 N 50th St, Milwaukee, WI 53210-2815 | 2019-08-15 |
1942856091 | Kennedy's Circle of Wellness LLC | Community/Behavioral Health | 3614 W North Ave, Milwaukee, WI 53208-1416 | 2019-08-14 |
1104386101 | Counseling Center | Community/Behavioral Health | 601 N 5th St, Sheboygan, WI 53081-4624 | 2019-03-25 |
1205391828 | Jerome Pitchford | Community/Behavioral Health | 1220 W Atkinson Ave, Milwaukee, WI 53206-3024 | 2019-02-07 |
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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.