Healthcare Provider Details

I. General information

NPI: 1831448091
Provider Name (Legal Business Name): ASSOCIATES IN PSYCHOTHERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2012
Last Update Date: 08/14/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4700 DRESSER DR STE 100
JANESVILLE WI
53546-9160
US

IV. Provider business mailing address

4700 DRESSER DR STE 100
JANESVILLE WI
53546-9160
US

V. Phone/Fax

Practice location:
  • Phone: 608-752-7255
  • Fax: 608-752-6942
Mailing address:
  • Phone: 608-752-7255
  • Fax: 608-752-6942

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number StateWI
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateWI
# 4
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: CAROL ANN WARD
Title or Position: CLINIC DIRECTOR
Credential: MS, LPC, NCC
Phone: 608-752-7255