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NPI Code Detail

MEDICARE: OAKWOOD CLINICAL ASSOCIATES, LTD

MEDICARE: OAKWOOD CLINICAL ASSOCIATES, LTD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) CounselorWI
2101YP2500XProfessional CounselorWI
31041C0700XClinical Social WorkerWI
4261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)WI

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
284521OTHERWIMEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1447289434
Entity Type Code : Organization
Provider Name (Legal Business Name) : OAKWOOD CLINICAL ASSOCIATES, LTD
Provider Business Mailing Address
First Line : 4109 67TH ST
Second Line :
City : KENOSHA
State : WI
Zip : 53142-3836
Country : US
Telephone Number : 262-652-9830
Fax Number : 262-652-2931
Provider Business Practice Location Address
First Line : 4109 67TH ST
Second Line :
City : KENOSHA
State : WI
Zip : 53142-3836
Country : US
Telephone Number : 262-652-9830
Fax Number : 262-652-2931
Authorized Official
Title or Position : PSYCHOTHERAPIST
Name : AMY B ANDERSON
Credential : MSW
Telephone Number : 262-652-9830
Provider Enumeration Date : 07/02/2006
Last Update Date : 03/18/2015

Similar Medicare Providers

1790916278 — MS. NICOLE VIENNA GUSTAFSON L.P.C.
Practice Location Address:
4109 67TH ST
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1154352052 — JEANNIE SEEFELDT CSW, CADC III
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1295766186 — AMY B ANDERSON MSW
Practice Location Address:
4109 67TH ST
KENOSHA, WI
53142-3836
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1598796492 — LISA RIOS-OLIVARES MSW
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4109 67TH ST
KENOSHA, WI
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1265463152 — JANE POHL MSW
Practice Location Address:
4109 67TH ST
KENOSHA, WI
53142-3836
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1700811965 — LISA SACHS MSW
Practice Location Address:
4109 67TH ST
KENOSHA, WI
53142-3836
Practice Phone: 262-652-9830
Practice Fax: 262-652-2931

Directions to “OAKWOOD CLINICAL ASSOCIATES, LTD ” Practice Location

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