DIVERSE CLINICAL SERVICES ASSOCIATES, INC. (NPI# 1528160314) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528160314 |
| Entity Type | Organization |
| Organization Name | DIVERSE CLINICAL SERVICES ASSOCIATES, INC. |
| Practice Address |
633 W Wisconsin Ave Suite 330 Milwaukee WI 53203-1918 |
| Practice Telephone | 4143474063 |
| Practice Fax Number | 4143474075 |
| Mailing Telephone | 4143474063 |
| Mailing Fax Number | 4143474075 |
| Enumeration Date | 2006-09-02 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | BASILISA VIRELLA (DIRECTOR) |
| Authorized Official Telephone | 4143477063 |
| Authorized Official Credential | PH.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 103TC1900X |
Psychologist Specialization: Counseling |
2692-123 | WI | Behavioral Health & Social Service Providers |
| X | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
27318020 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 39704500 | 05 | |
| WI | 31786300 | 05 | |
| WI | 42206700 | 05 |
| Street Address |
633 W WISCONSIN AVE SUITE 330 |
| City | MILWAUKEE |
| State | WI |
| Zip Code | 53203-1918 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659376820 | Mary T. Bernacchi | Pharmacist | 633 W Wisconsin Ave, Ste 1100, Milwaukee, WI 53203-1907 | 2005-06-15 |
| 1194158915 | Horizon Healthcare, Inc | Counselor | 633 W Wisconsin Ave, Suite 1810, Milwaukee, WI 53203-1908 | 2013-08-15 |
| 1275975807 | Sandra Eiler | Counselor | 633 W Wisconsin Ave, Suite 1810, Milwaukee, WI 53203 | 2013-07-24 |
| 1225281058 | Ronald G. Rubin, M.d., S.c. | Psychiatry & Neurology | 633 W Wisconsin Ave, Suite 1810, Milwaukee, WI 53203-1918 | 2008-10-24 |
| 1851571715 | Miller Home Care LLC | Home Health | 633 W Wisconsin Ave, #1500, Milwaukee, WI 53203-1918 | 2007-11-08 |
| 1366420150 | Victoria Fetter | Psychiatry & Neurology | 633 W Wisconsin Ave, Ste 401, Milwaukee, WI 53203-1918 | 2006-01-03 |
| 1699764167 | Thomas A. Garland Iv | Counselor | 633 W Wisconsin Ave, Suite #1810, Milwaukee, WI 53203-1918 | 2005-10-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013463272 | Kameela Jackson | Registered Nurse | 606 E Juneaue Ave. 511812, Milwaukee, WI 53203 | 2016-08-28 |
| 1528239928 | Christina Marie Sauber | Physical Therapy Assistant | 111 W. Michigan Street, Milwaukee, WI 53203 | 2008-03-13 |
| 1720273493 | Michelle Lynn Vogel | Speech-Language Pathologist | 111 West Michigan St, Prostep/extendicare Healthservices, Milwaukee, WI 53203 | 2007-09-06 |
| 1265572564 | Eye Care of Wisconsin, Inc | Health Maintenance Organization | 740 North Plankinton Ave, #730b, Milwaukee, WI 53203 | 2007-02-07 |
| 1073687349 | Riverwalk Psychotherapy Associates, LLC | Social Worker | 1110 N. Old World Third St., Suite 401, Milwaukee, WI 53203 | 2006-11-20 |
| 1144793423 | Carissa Deanna Basile | Behavioral Analyst | 525 N 6th St, Milwaukee, WI 53203 | 2019-01-09 |
| 1154693331 | Walgreen Co. | Durable Medical Equipment & Medical Supplies | 826 N Plankinton Ave Ste 100, Milwaukee, WI 53203 | 2012-02-02 |
| 1821277310 | Rosalie C Mackay | Community Health Worker | 111 W Michigan St, Prostep/extendicare Health Services, Milwaukee, WI 53203 | 2007-10-31 |
| 1023131240 | Gina G Negrette | Psychiatry & Neurology | 820 N Plankinton Ave, Milwaukee, WI 53203 | 2007-04-10 |
| 1255488292 | Melinda Hughes | Counselor | 1110 N Old World 3rd St, Suite 401, Milwaukee, WI 53203-1100 | 2007-01-04 |
| Find all providers in zip 53203 | ||||
| Taxonomy Code | 103TC1900X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Counseling |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134769441 | Graham Gardner Knowlton | Psychologist | Milwaukee Vamc 5000 W National Ave, Milwaukee, WI 53295-0001 | 2020-01-14 |
| 1467095703 | Ifrah Hameed | Psychologist | 1849 N Doctor M.l.k. Jr Dr# 101, Milwaukee, WI 53212 | 2019-10-18 |
| 1790202851 | Wisconsin Lutheran Child & Family Service | Psychologist | 2669 N Richards St, Milwaukee, WI 53212-2850 | 2017-08-29 |
| 1003100439 | Donald Raymond Hands | Psychologist | 6500 N Elm Tree Rd, Milwaukee, WI 53217-4042 | 2011-06-02 |
| 1376745182 | Mindy Marcus | Psychologist | Clemente J Zablocki Medical Ctr, 5000 W. National Ave, Milwaukee, WI 53295-0001 | 2007-06-04 |
| 1134332760 | Michael B Stillman | Psychologist | 8855 N Port Washington Rd, Apt. # 114, Milwaukee, WI 53217-1631 | 2007-05-08 |
| 1598371734 | Cristina Marie Soto Sullivan | Psychologist | 2524 E Webster Pl Ste 203, Milwaukee, WI 53211-4257 | 2020-09-22 |
| 1023655362 | Kavitha Dharmalingam Venkateswaran | Psychologist | 5000 W National Ave, Milwaukee, WI 53295-0001 | 2019-12-05 |
| 1336709849 | Nancy Harwood Nedland | Psychologist | 8901 W Capitol Dr, Milwaukee, WI 53222-1706 | 2019-06-17 |
| 1760992788 | Milwaukee Psychotherapy Collaborative | Psychologist | 9120 W Hampton Ave Ste 212, Milwaukee, WI 53225-4960 | 2017-10-04 |
| Find all providers in MILWAUKEE | ||||
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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.