BROTOLOC OUTPATIENT CLINIC (NPI# 1700928017) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700928017 |
| Entity Type | Organization |
| Organization Name | BROTOLOC OUTPATIENT CLINIC |
| Other Organization Name | BROTOLOC |
| Practice Address |
5812 W Burnham St West Allis WI 53219-1524 |
| Mailing Address |
5812 West Burnham Street West Allis WI 53219 |
| Practice Telephone | 4145433200 |
| Practice Fax Number | 4145433269 |
| Mailing Telephone | 4145433200 |
| Mailing Fax Number | 4145433269 |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DOUGLAS SVEDA (DIRECTOR) |
| Authorized Official Telephone | 4145433200 |
| Authorized Official Credential | MSW |
| 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) |
1114 | WI | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 42207400 | 05 |
| Other Name | Type Code |
|---|---|
| Brotoloc | Doing Business As Name - Organization |
| Street Address |
5812 W BURNHAM ST |
| City | WEST ALLIS |
| State | WI |
| Zip Code | 53219-1524 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437472966 | Brotoloc South, Inc. | Non-emergency Medical Transport (VAN) | 5812 W Burnham St, West Allis, WI 53219-1524 | 2010-03-11 |
| 1982933503 | Brotoloc South, Inc. | Clinic/Center | 5812 W Burnham St, West Allis, WI 53219-1524 | 2009-12-10 |
| 1447460217 | Douglas E. Sveda | Social Worker | 5812 W Burnham St, West Allis, WI 53219-1524 | 2007-05-23 |
| 1164565909 | Brotoloc Sesmv | Non-emergency Medical Transport (VAN) | 5812 W Burnham St, West Allis, WI 53219-1524 | 2007-02-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588262323 | Tammi T Wisniewski | Hearing Instrument Specialist | 4847 W. Forest Home Avenue, Greenfield, WI 53219 | 2020-10-14 |
| 1174052344 | Adam Blaha | Physical Therapy Assistant | 2622 South 66th Street, Milwaukee, WI 53219 | 2017-06-09 |
| 1700281920 | Mary Beth Menarek | Counselor | 6574 W. Beloit Road, West Allis, WI 53219 | 2014-10-30 |
| 1780959767 | James Stanley Ziolkowski | Electrodiagnostic Medicine | 9330 W. Lincln Ave, West Allis, WI 53219 | 2012-03-09 |
| 1568752707 | Carey M Kromarek | Social Worker | 5757 W. Oklahoma Ave, Suite 203, Milwaukee, WI 53219 | 2011-04-08 |
| 1275834988 | Debra L Felzer | Registered Nurse | 7123 W Stuth Place, West Allis, WI 53219 | 2010-11-11 |
| 1528290327 | Miguel Angel Bautista | Acupuncturist | 4318 W. Foresthowe Ave., Milwaukee, WI 53219 | 2009-08-13 |
| 1629211487 | Ruth Irene Young | Physical Therapy Assistant | 2027 S. 79th Street, West Allis, WI 53219 | 2009-04-09 |
| 1053591818 | Linda St. Louis | Nurse Practitioner | 6030 W. Oklahoma Avenue, Milwaukee, WI 53219 | 2007-11-09 |
| 1811185812 | John Stuart Lanham | Podiatrist | 5720 W Oklahoma Avenue, Milwaukee, WI 53219 | 2007-10-04 |
| Find all providers in zip 53219 | ||||
| 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 |
|---|---|---|---|---|
| 1720497308 | New Beginnings Mental Health Clinic LLC. | Clinic/Center | 6754 W Beloit Rd, Ste 10, West Allis, WI 53219-2068 | 2014-08-07 |
| 1710237052 | Road To Recovery Behavorial Health Clinic, LLC | Clinic/Center | 7441 W Greenfield Ave, Suite 15, West Allis, WI 53214-4676 | 2012-09-13 |
| 1982933503 | Brotoloc South, Inc. | Clinic/Center | 5812 W Burnham St, West Allis, WI 53219-1524 | 2009-12-10 |
| 1003928391 | Stress Management & Mental Health Clinics | Clinic/Center | 10201 W Lincoln Ave, # 308, West Allis, WI 53227-2136 | 2006-08-31 |
| 1578523775 | Westlake Clinic, LLC | Clinic/Center | 10533 W National Ave, Suite 300, West Allis, WI 53227-2041 | 2006-03-23 |
| 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 | WEST ALLIS |
| Zip Code | 53219 |
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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.