TOMBOLO, LLC (NPI# 1407370398) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1407370398 |
Entity Type | Organization |
Organization Name | TOMBOLO, LLC |
Other Organization Name | CONNECTIONS |
Practice Address |
12545 W. Burleigh Rd. Suite 10 Brookfield WI 53005 |
Mailing Address |
12545 W Burleigh Rd Ste 10 Brookfield WI 53005-3101 |
Practice Telephone | (414) 708-5988 |
Mailing Telephone | 4147085988 |
Enumeration Date | 2017-08-01 |
Last Update Date | 2017-08-01 |
Authorized Official Name | MS. RENEE L. GENIN (PSYCHOTHERAPIST/CHILD SPECIALIST) |
Authorized Official Telephone | 4147085988 |
Authorized Official Credential | LCSW |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
7050-123 | WI | Ambulatory Health Care Facilities |
N | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
7050-123 | WI | Ambulatory Health Care Facilities |
Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
7050-123 | WI | Ambulatory Health Care Facilities |
Other Name | Type Code |
---|---|
Connections | Doing Business As Name - Organization |
Entity Type | Entity Name | Entity Address |
---|---|---|
New York State Corporations | TOMBOLO, LLC | 110 Riverside Drive, New York, New York 10024 |
Street Address |
12545 W. BURLEIGH RD. SUITE 10 |
City | BROOKFIELD |
State | WI |
Zip Code | 53005 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1154937621 | Nsk Precision Healing & Wellness | Acupuncturist | 17040 W. Greenfield Ave #6, Brookfield, WI 53005 | 2020-09-21 |
1033772124 | Dbt Consultants LLC | Social Worker | 200 S. Executive Drive, Ste. 101, Brookfield, WI 53005 | 2019-04-15 |
1780142588 | Ashley Wing | Registered Nurse | 405 Bishops Way, Apt 555, Brookfield, WI 53005 | 2019-03-11 |
1720509045 | Rss William Conner LLC | Dentist | 15455 W Bluemound Rd Ste 250, Brookfield, WI 53005 | 2017-06-28 |
1669926598 | Mackenzie Rondeau | Physical Therapist | 1905 N Calhoun Rd Ste 105, Brookfield, WI 53005 | 2016-08-09 |
1699159319 | Charles Alan Kass | Dentist | 12720 W. North Avenue, Brookfield, WI 53005 | 2015-07-13 |
1164804274 | Mary-catherine Nimphius | Counselor | 250 S. Sunny Slope Rd, #128, Brookfield, WI 53005 | 2015-06-25 |
1528447034 | Weighless Md, LLC | Dietitian, Registered | 14960 W. Greenfield Ave Suite 104, Brookfield, WI 53005 | 2015-05-29 |
1366837346 | Maegan Michelle Cook | Dentist | 13780 W Greenfield Ave Ste 780, Brookfield, WI 53005 | 2015-04-06 |
1427454867 | Ellen Alexandra Thomas | Counselor | 16275 W Wisconsin Ave, Apt 312, Brookfield, WI 53005 | 2014-11-12 |
Find all providers in zip 53005 |
Taxonomy Code | 261QM0801X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Mental Health (Including Community Mental Health Center) |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1639647597 | Franzolin Consulting Services LLC | Clinic/Center | 405 N Calhoun Rd Ste 201, Brookfield, WI 53005-5902 | 2018-11-08 |
1508081134 | Mislinski-zosel S.c. | Clinic/Center | 250 N Sunny Slope Rd Ste 129, Brookfield, WI 53005-4815 | 2007-04-17 |
1588720155 | Bray Inc | Clinic/Center | 16655 W Bluemound Road, Suite 300, Brookfield, WI 53005 | 2006-12-28 |
1417034893 | Suburban Counseling Services LLC | Clinic/Center | 675 N Brookfield Road, Suite 103, Brookfield, WI 53045 | 2006-11-01 |
1083252860 | Tgl Wellness | Clinic/Center | 1750 N Calhoun Rd, Brookfield, WI 53005-5037 | 2019-12-12 |
1083170732 | Gorecki Psychological Services LLC | Clinic/Center | 19275 W Capitol Dr Ste 200, Brookfield, WI 53045-2734 | 2019-02-19 |
1982016846 | Carol L Flanary, LLC | Clinic/Center | 12645 W Burleigh Rd, Suite 20, Brookfield, WI 53005-3102 | 2014-05-27 |
1093017196 | Michael J. Logan Md, Sc | Clinic/Center | 16535 W Bluemound Rd Ste 200, Brookfield, WI 53005-5906 | 2010-11-22 |
1407048481 | Mohammad S Mallick Md LLC | Clinic/Center | 1525 Liberty Ct, Brookfield, WI 53045-5327 | 2007-08-14 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1477151439 | Tetzlaff & Myhre Psychotherapy and Assessments, LLC | Clinic/Center | N55w37178 Roland St, Oconomowoc, WI 53066-5321 | 2020-10-13 |
1598377244 | Calming Journeys Counseling, S.c. | Clinic/Center | 220 Wisconsin Dells Pkwy S Ste 1, Wisconsin Dells, WI 53965-8305 | 2020-08-23 |
1811509979 | Natural Wisdom Counseling LLC | Clinic/Center | 1523 Wi-78 Trunk, Mount Horeb, WI 53572 | 2020-08-20 |
1245841089 | Integrated Counseling LLC | Clinic/Center | 7818 Big Sky Dr Ste 214, Madison, WI 53719-2840 | 2020-08-14 |
1629687108 | Premier Medical & Couple Therapy | Clinic/Center | 1025 W Glen Oaks Ln Ste 208, Mequon, WI 53092-3374 | 2020-07-30 |
1841809878 | Lifespan Psychotherapy | Clinic/Center | 510 Hartbrook Dr Ste 204b, Hartland, WI 53029-1440 | 2020-07-27 |
1114535929 | Eclipse Counseling LLC | Clinic/Center | 1136 Barron St, Eau Claire, WI 54703 | 2020-07-17 |
1275164709 | Katrina M. Johnson, LLC | Clinic/Center | 106 Passive Sun Drive, Soldiers Grove, WI 54655 | 2020-02-03 |
1316587439 | Sixteenth Street Community Health Centers, Inc. | Clinic/Center | 1635 W National Ave, Milwaukee, WI 53204-1130 | 2020-01-07 |
1386283034 | Mainstreet Counseling | Clinic/Center | 1717 11th St, Monroe, WI 53566-1839 | 2019-12-29 |
Find all providers with the same taxonomy |
City | BROOKFIELD |
Zip Code | 53005 |
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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.