COMMUNITY COUNSELING & EVALUATION SERVICES, LLC (NPI# 1700390374) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700390374 |
| Entity Type | Organization |
| Organization Name | COMMUNITY COUNSELING & EVALUATION SERVICES, LLC |
| Practice Address |
115 S Main St Jefferson WI 53549-1631 |
| Mailing Address |
125 E Woolcock St Jefferson WI 53549-1234 |
| Practice Telephone | 9207281125 |
| Mailing Telephone | 9207281125 |
| Enumeration Date | 2017-11-18 |
| Last Update Date | 2017-11-18 |
| Authorized Official Name | MS. TAMMY JANE KING (CEO) |
| Authorized Official Telephone | 9207281125 |
| Authorized Official Credential | LCSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
6752-123 | WI | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | INDIVIDUAL | 1851710909 | 01 |
| Street Address |
115 S MAIN ST |
| City | JEFFERSON |
| State | WI |
| Zip Code | 53549-1631 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851710909 | Tammy J. King | Social Worker | 115 S Main St, Jefferson, WI 53549-1631 | 2014-04-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740804913 | Anna E Warzala | Licensed Practical Nurse | Sunset Ridge Jefferson, 826 E. Reinel Street, Jefferson, Wi 53549, Jefferson, WI 53549 | 2020-06-03 |
| 1023428083 | Mary Beth Breunig | Occupational Therapist | 206 South Taft Avenue, Jefferson, WI 53549 | 2014-04-30 |
| 1841639952 | Debra Lee Schoenike | Licensed Practical Nurse | 610 S Main Street, Jefferson, WI 53549 | 2013-06-21 |
| 1073762191 | Katherine Sue Drechsler | Counselor | 1541 Annex Road, Jefferson, WI 53549 | 2008-09-12 |
| 1497960645 | Family Resources Associates Inc | Counselor | 248 S Wisconsin Drive, Jefferson, WI 53549 | 2007-05-11 |
| 1386707529 | Todd G Goldbeck | Physical Therapist | 1515 Highway 26 South, Jefferson, WI 53549 | 2006-12-19 |
| 1982780813 | Sport & Spine Clinic of Fort Atkinson Limited Partnership | Physical Therapist | 222 S Wisconsin Drive, Suite 3, Jefferson, WI 53549 | 2006-10-31 |
| 1033202528 | Marie Ann Maxwell-jones | Occupational Therapist | N3995 Annex Road, Jefferson, WI 53549 | 2006-10-02 |
| 1447216551 | Diane Mary Voelker | Registered Nurse | 224 Connelly D R, Jefferson, WI 53549 | 2006-04-26 |
| 1063477065 | Cynthia Lynn Miller | Registered Nurse | W4949 Streim Lane, Jefferson, WI 53549 | 2006-04-20 |
| Find all providers in zip 53549 | ||||
| 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] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 | ||||
Please comment or provide details below to improve the information on COMMUNITY COUNSELING & EVALUATION SERVICES, LLC.
| 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.