AGNESIAN HEALTHCARE INC (NPI# 1760902191) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760902191 |
| Entity Type | Organization |
| Organization Name | AGNESIAN HEALTHCARE INC |
| Other Organization Name | AGNESIAN BEYOND BOUNDARIES OF AUTISM |
| Practice Address |
40 Camelot Dr Fond Du Lac WI 54935-8049 |
| Practice Telephone | (920) 907-8201 |
| Mailing Telephone | 9209078201 |
| Enumeration Date | 2017-06-27 |
| Last Update Date | 2017-06-27 |
| Authorized Official Name | BONNIE R SCHMITZ (VP & CFO) |
| Authorized Official Telephone | 9209264480 |
| 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) |
2226 | WI | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Agnesian Beyond Boundaries of Autism | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154947737 | Agnesian Healthcare Inc | Preventive Medicine | 250 Camelot Dr, Fond Du Lac, WI 54935-8029 | 2020-06-19 |
| 1417918640 | Agnesian Healthcare Inc | Durable Medical Equipment & Medical Supplies | 601 E Clark St, Brandon, WI 53919-9549 | 2006-03-29 |
| 1518928662 | Agnesian Healthcare Inc | Durable Medical Equipment & Medical Supplies | 703 W State St, Fox Lake, WI 53933-9550 | 2006-03-29 |
| 1275594327 | Agnesian Healthcare Inc | Durable Medical Equipment & Medical Supplies | 1175b N Margaret St, Markesan, WI 53946-8517 | 2006-03-29 |
| 1831715721 | Agnesian Healthcare Inc | Preventive Medicine | 420 E Division St, Fond Du Lac, WI 54935-4560 | 2020-06-17 |
| 1215402334 | Agnesian Healthcare Inc | Durable Medical Equipment & Medical Supplies | 250 Corporate Dr, Beaver Dam, WI 53916-3115 | 2018-10-04 |
| 1487990651 | Agnesian Healthcare Inc | Durable Medical Equipment & Medical Supplies | 21 S Marr St, Fond Du Lac, WI 54935-4334 | 2012-12-17 |
| 1962748319 | Agnesian Healthcare Inc | Durable Medical Equipment & Medical Supplies | 451 E Brooklyn St, Chilton, WI 53014-1595 | 2012-12-12 |
| 1437405925 | Agnesian Healthcare Inc | Chiropractor | 525 E Division St, Fond Du Lac, WI 54935-3747 | 2012-08-02 |
| 1972879641 | Agnesian Healthcare Inc | Durable Medical Equipment & Medical Supplies | 1001 W Main St, Waupun, WI 53963-1601 | 2012-03-28 |
| Street Address |
40 CAMELOT DR |
| City | FOND DU LAC |
| State | WI |
| Zip Code | 54935-8049 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639243710 | Patricia Ann O'hearn | Counselor | 40 Camelot Dr, Fond Du Lac, WI 54935-8049 | 2006-11-20 |
| 1700414489 | Heather A Beaudoin | Social Worker | 40 Camelot Dr, Fond Du Lac, WI 54935-8049 | 2020-03-30 |
| 1437791431 | Emily Connovich | Behavior Technician | 40 Camelot Dr, Fond Du Lac, WI 54935-8049 | 2019-10-10 |
| 1598314973 | Danyel Lynn Syms | Social Worker | 40 Camelot Dr, Fond Du Lac, WI 54935-8049 | 2019-09-09 |
| 1417517558 | Krista Schmitz | Behavior Technician | 40 Camelot Dr, Fond Du Lac, WI 54935-8049 | 2019-06-20 |
| 1346808185 | Makenna Mitchell | Behavioral Analyst | 40 Camelot Dr, Fond Du Lac, WI 54935-8049 | 2019-06-05 |
| 1174091888 | David Francione | Social Worker | 40 Camelot Dr, Fond Du Lac, WI 54935-8049 | 2018-11-12 |
| 1255704201 | Bryan Mischler | Social Worker | 40 Camelot Dr, Fond Du Lac, WI 54935-8049 | 2015-11-12 |
| 1841404258 | Elizabeth Scott Rogers-doll | Psychologist | 40 Camelot Dr, Fond Du Lac, WI 54935-8049 | 2007-05-09 |
| 1942429949 | Anne Clair Brunette | Social Worker | 40 Camelot Dr, Fond Du Lac, WI 54935-8049 | 2007-04-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609482249 | Keziah Sherri Love | Counselor | W390 Wi-23, Fond Du Lac, WI 54935 | 2020-09-18 |
| 1891341988 | Cynthia Louise Singleton | Nurse Practitioner | 16 E 13th St., Fond Du Lac, WI 54935 | 2019-08-14 |
| 1083183297 | Elena Alexandra Giese | Nurse Practitioner | 430 E. Division St, Fond Du Lac, WI 54935 | 2018-11-16 |
| 1669963740 | Elizabeth Anne Machi | Student in an Organized Health Care Education/Training Program | 885 Western Ave Ste 300, Fond Du Lac, WI 54935 | 2018-05-23 |
| 1184150021 | Jordan Moehn | Specialist/Technologist | 633 Prairie Pkwy, Fond Du Lac, WI 54935 | 2017-05-11 |
| 1467856336 | Chuentao Ho | Specialist/Technologist | 45 South National Ave., Fond Du Lac, WI 54935 | 2014-10-21 |
| 1437587961 | Paula Seeley | Nurse Practitioner | 63 West Pioneer Rd, Fond Du Lac, WI 54935 | 2013-10-18 |
| 1144516030 | Bonnie Kay Mallon | Registered Nurse | 118 E 9th St, Fond Du Lac, WI 54935 | 2011-06-20 |
| 1770885600 | Holly Shepard | Counselor | 23 W Scott St., Fond Du Lac, WI 54935 | 2010-11-29 |
| 1437479110 | Ruth Marie Bohn | Occupational Therapy Assistant | 244 North Macy Street, Fond Du Lac, WI 54935 | 2010-06-04 |
| Find all providers in zip 54935 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669521233 | Delta Center LLC | Clinic/Center | 196 E Third Street, Fond Du Lac, WI 54935 | 2007-01-10 |
| 1053941096 | Positive Clinical Concepts | Clinic/Center | 498 Ruggles St, Fond Du Lac, WI 54935-3931 | 2020-01-17 |
| 1841320884 | Agnesian Healthcare Inc | Clinic/Center | 40 Camelot Dr, Fond Du Lac, WI 54935-8049 | 2007-03-07 |
| 1487712519 | Associated Counseling and Recovery Center LLC | Clinic/Center | 551 W Johnson St, Fond Du Lac, WI 54935 | 2006-12-04 |
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| 1811509979 | Natural Wisdom Counseling LLC | Clinic/Center | 1523 Wi-78 Trunk, Mount Horeb, WI 53572 | 2020-08-20 |
| 1245841089 | Integrated Counseling LLC | Clinic/Center | 7818 Big Sky Dr Ste 214, Madison, WI 53719-2840 | 2020-08-14 |
| 1629687108 | Premier Medical & Couple Therapy | Clinic/Center | 1025 W Glen Oaks Ln Ste 208, Mequon, WI 53092-3374 | 2020-07-30 |
| 1841809878 | Lifespan Psychotherapy | Clinic/Center | 510 Hartbrook Dr Ste 204b, Hartland, WI 53029-1440 | 2020-07-27 |
| 1114535929 | Eclipse Counseling LLC | Clinic/Center | 1136 Barron St, Eau Claire, WI 54703 | 2020-07-17 |
| 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 |
| Find all providers with the same taxonomy | ||||
| City | FOND DU LAC |
| Zip Code | 54935 |
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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.