COLUMBIA COUNTY COMMUNITY SUPPORT PROGRAM (NPI# 1467487538) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467487538 |
| Entity Type | Organization |
| Organization Name | COLUMBIA COUNTY COMMUNITY SUPPORT PROGRAM |
| Other Organization Name | PAUQUETTE CENTER |
| Practice Address |
2901 Hunters Trl Portage WI 53901-3403 |
| Mailing Address |
Po Box 301 Portage WI 53901-0301 |
| Practice Telephone | 6087425344 |
| Practice Fax Number | 6087424087 |
| Mailing Telephone | 6087425344 |
| Mailing Fax Number | 6087424087 |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | PAM POLZER (DIRECTOR) |
| Authorized Official Telephone | 6087425344 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
1212 | WI | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 43429300 | 05 |
| Other Name | Type Code |
|---|---|
| Pauquette Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154595551 | Columbia County Community Support Program | Clinic/Center | 2901 Hunters Trl, Portage, WI 53901-3403 | 2008-04-16 |
| Street Address |
2901 HUNTERS TRL |
| City | PORTAGE |
| State | WI |
| Zip Code | 53901-3403 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912973942 | Andrew Taylor Putney | Family Medicine | 2901 Hunters Trl, Portage, WI 53901-3403 | 2006-02-28 |
| 1164086112 | Claire A Staley | Social Worker | 2901 Hunters Trl, Portage, WI 53901-3403 | 2019-04-25 |
| 1467826990 | Renee Birkholz | Counselor | 2901 Hunters Trl, Portage, WI 53901-3403 | 2015-11-20 |
| 1710363031 | Tomi Randall | Counselor | 2901 Hunters Trl, Portage, WI 53901-3403 | 2015-08-10 |
| 1144618604 | Kristine G Schmitt | Counselor | 2901 Hunters Trl, Portage, WI 53901-3403 | 2015-01-06 |
| 1700287216 | Jill Dickson-baures | Psychologist | 2901 Hunters Trl, Portage, WI 53901-3403 | 2014-09-16 |
| 1376944504 | Meredith Sullivan | Counselor | 2901 Hunters Trl, Portage, WI 53901-3403 | 2014-09-08 |
| 1619377223 | Bjorn Hanson | Psychologist | 2901 Hunters Trl, Portage, WI 53901-3403 | 2014-09-02 |
| 1649697988 | Elizabeth Abbs Erickson | Counselor | 2901 Hunters Trl, Portage, WI 53901-3403 | 2014-03-25 |
| 1124259841 | Robin A Deethardt | Counselor | 2901 Hunters Trl, Portage, WI 53901-3403 | 2009-07-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740710748 | Robert James Corliss | Internal Medicine | St. Vincent Fmc, 140east Cook St., Portage, WI 53901 | 2017-06-13 |
| 1639328867 | Casey Jo Ambort | Speech-Language Pathologist | 626 East Slifer St, Portage, WI 53901 | 2008-09-11 |
| 1871767400 | Planned Parenthood of Wi, Inc | Non-Pharmacy Dispensing Site | 132 W. Cook St., Portage, WI 53901 | 2008-04-15 |
| 1881872158 | Marta Jean Jindra | Physical Therapist | 626 E Slifer Street, Portage, WI 53901 | 2008-02-08 |
| 1699953976 | Lana Marie Edwards | Speech-Language Pathologist | 626 East Slifer Street, Portage, WI 53901 | 2008-02-08 |
| 1134314552 | Kristina Hellenbrand | Physical Therapist | 2639 New Pinery Road, Suite 2, Portage, WI 53901 | 2007-09-10 |
| 1689727810 | Gregory Allan Bindl | Chiropractor | 2121new Pinery Rd, Portage, WI 53901 | 2007-01-19 |
| 1720149156 | Timothy J Rosin Dds Sc | Dentist | 2570 New Pinery Rd, Portage, WI 53901 | 2006-12-12 |
| 1710083779 | Currani Seubert Dental Office LLC | Dentist | 260 W Cook St, Portage, WI 53901 | 2006-09-16 |
| 1225090525 | University of Wisconsin Medical Foundation Inc | Durable Medical Equipment & Medical Supplies | 2977 Cty Hwy Cx, Portage, WI 53901 | 2006-04-04 |
| Find all providers in zip 53901 | ||||
| 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 |
|---|---|---|---|---|
| 1487295093 | Lotus Counseling Services, LLC | Clinic/Center | 6360 E Main St Apt 109, Portage, IN 46368-4683 | 2019-10-04 |
| 1164881207 | Family & Children Services, Inc. | Clinic/Center | 1302 W Milham Ave, Portage, MI 49024 | 2016-02-17 |
| 1932757937 | Healthy Mind Fit Body | Clinic/Center | 7901 S 12th St Ste 201, Portage, MI 49024-3831 | 2019-09-03 |
| 1073835393 | Compass Counseling, LLC | Clinic/Center | 1508 New Pinery Rd, Portage, WI 53901-1312 | 2010-03-01 |
| 1780610923 | Community Service Associates | Clinic/Center | 2901 Hunters Trl, Portage, WI 53901-3403 | 2006-06-22 |
| 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 | ||||
Please comment or provide details below to improve the information on COLUMBIA COUNTY COMMUNITY SUPPORT PROGRAM.
| 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.