RUSS KINKADE, PSY.D., S.C.


Address: 6214 Washington Ave, C-10, Mount Pleasant, WI 53406-3986
Phone: 2629895228

RUSS KINKADE, PSY.D., S.C. (NPI# 1992195192) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1992195192
Entity Type Organization
Organization Name RUSS KINKADE, PSY.D., S.C.
Practice Address 6214 Washington Ave
C-10
Mount Pleasant
WI 53406-3986
Mailing Address S55w29307 Holiday Point Dr
Waukesha
WI 53189-9026
Practice Telephone 2629895228
Practice Fax Number 2628789285
Mailing Telephone 2629895228
Mailing Fax Number 2628789285
Enumeration Date 2015-01-27
Last Update Date 2015-01-27
Authorized Official Name DR. RUSSELL WILLIAM KINKADE JR. (PRESIDENT)
Authorized Official Telephone 2629895228
Authorized Official Credential PSY.D.
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261Q00000X Clinic/Center 1296 WI Ambulatory Health Care Facilities

Office Location

Street Address 6214 WASHINGTON AVE
C-10
City MOUNT PLEASANT
State WI
Zip Code 53406-3986

Providers in the same location

NPI Name Taxonomy Address Enumeration
1467588590 Barbara B Mizer Social Worker 6214 Washington Ave, Suite C10, Mount Pleasant, WI 53406-3986 2007-02-25
1629696083 Barbara Gail Demilio Social Worker 6214 Washington Ave, Mount Pleasant, WI 53406-3986 2020-07-10
1811388721 Nulife Therapy Services, LLC Community/Behavioral Health 6214 Washington Ave, Suite C-3, Mount Pleasant, WI 53406-3986 2015-02-13

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1578164349 Lynn Huynh Pharmacist 5695 Washington Ave, Racine, WI 53406 2020-11-06
1659920049 Carol Jean Cornejo Technician 6528 Heritage Avenue, Mt Pleasant, WI 53406 2019-09-09
1265913958 Mary Goldbeck Social Worker 1775 Newman Rd, Mt Pleasant, WI 53406 2018-08-22
1669963344 Kelly Nicole Nelson Registered Nurse 8800 Washington Ave Ste 200, Mount Pleasant, WI 53406 2018-05-29
1891212163 Ilona Agata Pryomski Nurse Practitioner 9201 Washington Ave, Racine, WI 53406 2017-08-27
1386185106 Margaret M. Abaogye Dds Dentist 4340 Newman Rd., Racine, WI 53406 2017-03-13
1508309212 Rebecca Koeppen Dietitian, Registered 8400 Washington Ave., Racine, WI 53406 2016-11-29
1386194371 Forefront Dermatology, S.c. Dermatology 7200 Washington Ave, Suite 100, Mount Pleasant, WI 53406 2016-10-13
1356891402 Forefront Dermatology, S.c. Dermatology 1515 S Green Bay Rd, Racine, WI 53406 2016-10-12
1861841470 Leah Marie Johnson Dentist 1101 South Airline Road, Racine, WI 53406 2016-06-06
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Taxonomy Information

Taxonomy Code 261Q00000X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center

Taxonomy Definition

A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1750865622 Merge Medical Analytics Clinic/Center 180 Wingo Way Ste 106, Mount Pleasant, SC 29464-1810 2018-09-18
1720444524 Therapy Learning Center, East Texas Clinic Clinic/Center 910 Holly Hill Ln, Mount Pleasant, TX 75455-5865 2016-01-08
1073892873 Imagine Chiropractic PC Clinic/Center 952 Houston Northcutt Blvd, Suite 201, Mount Pleasant, SC 29464-5659 2011-08-10
1952619116 Rabin Chiropractic Center Clinic/Center 712 S Shelmore Blvd, 105, Mount Pleasant, SC 29464-3449 2010-09-21
1255526141 Charleston Midwife Services Clinic/Center 1300 Hospital Dr Ste 270, Mount Pleasant, SC 29464-3244 2007-09-13
1639568231 Mount Pleasant Pediatric Therapy Clinic/Center 85 Vincent Dr # C, Mount Pleasant, SC 29464-4066 2015-01-20
1194065920 Dr. Addison B. Nelson LLC Clinic/Center 874 Whipple Rd, 200, Mount Pleasant, SC 29464-8900 2013-02-14
1194009563 5 Elements Health & Wellness, LLC Clinic/Center 1524 S Green Bay Rd, Back In Action/5 Elements, Mount Pleasant, WI 53406-5788 2011-10-04
1417150186 Belle Hall Chiropractic, LLC Clinic/Center 721 Long Point Rd, Suite 403, Mount Pleasant, SC 29464-8297 2007-06-08
1861605537 Tlc The Laser Center (institute) Inc. Clinic/Center 709 Long Point Rd, Ste C, Mount Pleasant, SC 29464-8287 2007-05-08
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Competitor

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City MOUNT PLEASANT
Zip Code 53406

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Dataset Information

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.

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