Healthcare Provider Details

I. General information

NPI: 1992718589
Provider Name (Legal Business Name): CAPITOL ASSOCIATES, SC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2006
Last Update Date: 09/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

440 SCIENCE DR., STE 200
MADISON WI
53711
US

IV. Provider business mailing address

440 SCIENCE DR., STE 200
MADISON WI
53711
US

V. Phone/Fax

Practice location:
  • Phone: 608-238-5176
  • Fax: 608-238-2727
Mailing address:
  • Phone: 608-238-5176
  • Fax: 608-238-2727

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. JOHNA GERASCH
Title or Position: PRESIDENT
Credential: PHD
Phone: 608-238-5176