JANESVILLE PSYCHIATRIC CLINIC OF MAIN (NPI# 1598149403) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598149403 |
| Entity Type | Organization |
| Organization Name | JANESVILLE PSYCHIATRIC CLINIC OF MAIN |
| Other Organization Name | BC PSYCHIATRIC CLINIC |
| Practice Address |
2010 Parkside Dr Janesville WI 53548-6613 |
| Practice Telephone | 6084366161 |
| Mailing Telephone | 6084366161 |
| Enumeration Date | 2015-07-10 |
| Last Update Date | 2015-07-20 |
| Authorized Official Name | MR. WILLIAM LEE HOLLINGSWORTH (DIRECTOR) |
| Authorized Official Telephone | 6084366161 |
| Authorized Official Credential | MS |
| Is Organization Subpart | Y |
| Parent Organization Name | JANESVILLE PSYCHIATRIC CLINIC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251S00000X | Community/Behavioral Health | 162 - 124, 366 - | WI | Agencies |
| Y | 251S00000X | Community/Behavioral Health | 3044- 123 | WI | Agencies |
| Other Name | Type Code |
|---|---|
| BC Psychiatric Clinic | Doing Business As Name - Organization |
| Street Address |
2010 PARKSIDE DR |
| City | JANESVILLE |
| State | WI |
| Zip Code | 53548-6613 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578846010 | Patricia Ann Sheets | Licensed Vocational Nurse | 316 N. Terrace St., Janbesville, WI 53548 | 2011-09-21 |
| 1760658983 | Kristy Kay Prentice Kerl | Dental Hygienist | 121 Jonathon Dr, Janesville, WI 53548 | 2008-05-07 |
| 1316005978 | City of Janesville | Emergency Medical Technician, Paramedic | 18 N Jackson St, Janesville, WI 53548 | 2006-12-05 |
| 1558464115 | Sarah Louise Hessenauer | Social Worker | 17 S. River St, Suite 254, Janesville, WI 53548 | 2006-09-07 |
| 1073548327 | Mary Katherine Cefalu | Registered Nurse | 17 S. River, Suite 254, Janesville, WI 53548 | 2006-07-12 |
| 1699707950 | Gary Lavern Jones | Counselor | 175 River, Suite 254, Janesville, WI 53548 | 2006-07-07 |
| 1295767424 | Michael Stuart Kaye | Clinical Neuropsychologist | 17 S River St Ste 254, Janesville, WI 53548 | 2006-07-07 |
| 1205864055 | Amy Laurie Roy | Counselor | 17 S River Suite 254, Janesville, WI 53548 | 2006-06-29 |
| 1518903566 | Leota I Larson | Psychologist | 17 S River, Suite 254, Janesville, WI 53548 | 2006-06-20 |
| 1760950414 | North Star Chiropractic LLC | Chiropractor | 21 S Jackson St, Ste 160, Janesville, WI 53548 | 2018-11-10 |
| Find all providers in zip 53548 | ||||
| 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 |
|---|---|---|---|---|
| 1124434816 | County of Rock County Clerk | Community/Behavioral Health | 3530 N Parker Dr, Janesville, WI 53545-0766 | 2014-07-02 |
| 1881849016 | Acs Clinical Services LLC | Community/Behavioral Health | 303 W Court St, Janesville, WI 53548-3811 | 2008-12-02 |
| 1831354794 | County of Rock County Clerk | Community/Behavioral Health | 3506 Hwy 51, Janesville, WI 53546 | 2008-07-21 |
| 1427221837 | Rock County Human Services Long Term Support | Community/Behavioral Health | 1900 Center Ave, Janesville, WI 53546-2801 | 2008-04-07 |
| 1366641250 | Drk Innovations | Community/Behavioral Health | 121 N Jackson St, Janesville, WI 53548-2929 | 2007-07-12 |
| 1275693178 | County of Rock | Community/Behavioral Health | 3530 N Cty Trk F, Janesville, WI 53547-0726 | 2006-12-11 |
| 1609027887 | Catholic Charities, Inc. Roman Catholic Diocese | Community/Behavioral Health | 2020 E Milwaukee St, #9, Janesville, WI 53545-2600 | 2008-10-06 |
| 1700050416 | County of Rock County Clerk | Community/Behavioral Health | 3506 N Us Highway 51, Janesville, WI 53545-0726 | 2008-04-15 |
| 1174796114 | Crisis Intervention Unit | Community/Behavioral Health | 3530 N County Rd E # F, Janesville, WI 53548-9074 | 2008-04-10 |
| 1669645768 | County of Rock County Clerk | Community/Behavioral Health | 3530 N Cty Trk F, Janesville, WI 53547 | 2008-04-09 |
| Find all providers in JANESVILLE | ||||
| City | JANESVILLE |
| Zip Code | 53548 |
Please comment or provide details below to improve the information on JANESVILLE PSYCHIATRIC CLINIC OF MAIN.
| 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.