Healthcare Provider Details

I. General information

NPI: 1700740636
Provider Name (Legal Business Name): CENTERPOINT SOMATIC THERAPY AND WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 SCHROEDER CT STE 120
MADISON WI
53711-2503
US

IV. Provider business mailing address

4134 BIRCH AVE
MADISON WI
53711-1607
US

V. Phone/Fax

Practice location:
  • Phone: 608-220-5996
  • Fax:
Mailing address:
  • Phone: 608-220-5996
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MAUREEN ELLEN GROSSE
Title or Position: LICENSED PROFESSIONAL COUNSELOR
Credential: LPC
Phone: 608-220-5996