INNOVATIVE WISCONSIN, LLC (NPI# 1871972349) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871972349 |
| Entity Type | Organization |
| Organization Name | INNOVATIVE WISCONSIN, LLC |
| Practice Address |
445 S Madison St Green Bay WI 54301-4101 |
| Practice Telephone | 9204310962 |
| Practice Fax Number | 9208841967 |
| Mailing Telephone | 9204310962 |
| Mailing Fax Number | 9208841967 |
| Enumeration Date | 2015-05-29 |
| Last Update Date | 2015-05-29 |
| Authorized Official Name | DRUE RAY (OFFICER) |
| Authorized Official Telephone | 8286848441 |
| Is Organization Subpart | Y |
| Parent Organization Name | INNOVATIVE SERVICES, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | WI | Agencies |
| Street Address |
445 S MADISON ST |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54301-4101 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790067890 | My Innovative Services | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 445 S Madison St, Green Bay, WI 54301-4126 | 2011-09-14 |
| 1437433562 | Innovative Services | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 445 S Madison St, Green Bay, WI 54301-4126 | 2011-10-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386102465 | Parc Village Dental, LLC | Dentist | 2805 Libal Street, Suite A, Green Bay, WI 54301 | 2019-03-07 |
| 1598229478 | Shaina Marie Conner | Registered Nurse | 835 S Vanburen St, Green Bay, WI 54301 | 2019-01-25 |
| 1093298960 | Brown County | Case Management | 111 N. Jefferson Street, Green Bay, WI 54301 | 2018-09-07 |
| 1639609928 | Frontline Healthcare LLC | Specialist/Technologist, Other | 2221 S. Webster Ave. Suite 270, Greenbay, WI 54301 | 2017-06-19 |
| 1992242606 | Charmaine Rimple | Counselor | 526 South Monroe Avenue, Green Bay, WI 54301 | 2017-01-20 |
| 1962944819 | Rebecca Lucille Reinbold | Registered Nurse | 917 Catherine Street, Green Bay, WI 54301 | 2016-11-09 |
| 1730635061 | Melissa Kristof | Specialist/Technologist, Other | 1821 Sounth Webster Ave., Green Bay, WI 54301 | 2016-08-28 |
| 1255709747 | Vivian Sweetheart Bishop-cook | Counselor | 2920 South Webster Ave, Green Bay, WI 54301 | 2015-09-14 |
| 1881079960 | Chelsi S Weber | Registered Nurse | 2300 Riverside Dr., Ste 204, Green Bay, WI 54301 | 2015-07-30 |
| 1962816371 | Joelle M Hesse | Counselor | 630 Cherry St., Green Bay, WI 54301 | 2014-06-13 |
| Find all providers in zip 54301 | ||||
| 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 |
|---|---|---|---|---|
| 1043725922 | Healthy Hope Counseling LLC | Community/Behavioral Health | 916 Willard Dr Ste 136, Green Bay, WI 54304-6223 | 2017-12-13 |
| 1801283494 | Abundant Life Counseling & Renewal Center LLC | Community/Behavioral Health | 1221 Bellevue St Ste 113, Green Bay, WI 54302-2155 | 2015-04-21 |
| 1609015569 | Occupational Health Services Inc. | Community/Behavioral Health | 2688 Vissers Ct, Green Bay, WI 54313-5856 | 2009-02-16 |
| 1417107590 | New Hope Counseling Center of Wi, Inc. | Community/Behavioral Health | 3021 Holmgren Way, #203, Green Bay, WI 54304-6302 | 2008-09-24 |
| 1699948471 | Robyn Rickert & Associates, LLC | Community/Behavioral Health | 130 E Walnut St Ste 406, Green Bay, WI 54301-4231 | 2008-04-11 |
| 1093869588 | Innovative Counseling Inc | Community/Behavioral Health | 1499 6th St, Innovative Counseling Inc, Green Bay, WI 54304-2252 | 2007-01-22 |
| 1497818454 | Christian Counseling Ministries, Inc. | Community/Behavioral Health | 2150 Memorial Dr, Suite #213, Green Bay, WI 54303-6335 | 2006-12-19 |
| 1063985620 | Mamma Gese | Community/Behavioral Health | 217 N Madison St Ste 4, Green Bay, WI 54301-5103 | 2019-01-07 |
| 1598117822 | Generations Community Services | Community/Behavioral Health | 217 N Madison St, Suite 5, Green Bay, WI 54301-5103 | 2016-07-11 |
| 1225441298 | Baeten Counseling & Consultation Team, S.c. | Community/Behavioral Health | 2920 S Webster Ave, Green Bay, WI 54301-1594 | 2014-06-08 |
| Find all providers in GREEN BAY | ||||
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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.