MIKAYLA T PHAN (NPI# 1720637507) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720637507 |
| Entity Type | Individual |
| Full Name | MIKAYLA T PHAN |
| Credential | MFT-IT |
| Practice Address |
437 S Yellowstone Dr Ste 212 Madison WI 53719-1061 |
| Practice Telephone | 6086306153 |
| Mailing Telephone | 6086306153 |
| Enumeration Date | 2019-09-05 |
| Last Update Date | 2020-03-23 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106H00000X | Marriage & Family Therapist | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 6333 Odana Rd Ste 20, Madison, WI 537191130 | 6082702511 |
| Street Address |
437 S YELLOWSTONE DR STE 212 |
| City | MADISON |
| State | WI |
| Zip Code | 53719-1061 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689271801 | Jessica Seidel | Registered Nurse | 1015 Gammon Lane, Madison, WI 53719 | 2020-10-01 |
| 1376168989 | 360 Wellness LLC | Physical Therapist | 504 S Yellowstone Lane, Madison, WI 53719 | 2020-06-09 |
| 1932744067 | Sara Ruiz | Marriage & Family Therapist | Clock Tower Office Park, 6333 Odana Rd, #20, Madison, WI 53719 | 2019-11-13 |
| 1700436466 | David R. Gosling | Counselor | 702 South High Point Road #209, Madison, WI 53719 | 2019-09-16 |
| 1285289587 | Clifton Leo Davis Jr. | Counselor | 6417 O Dana Rd #5, Madison, WI 53719 | 2019-08-05 |
| 1679127278 | Akillah Jamillah Wali | Psychologist | 6417 Odana Rd Suite 5, Madison, WI 53719 | 2019-07-31 |
| 1689230211 | Brandy Georgecopeland | Marriage & Family Therapist | 6417 Odana Rd. Ste 5, Madison, WI 53719 | 2019-05-20 |
| 1275016826 | Kelsey Andersen | Physical Therapist | 504 S. Yellowstone Lane, Madison, WI 53719 | 2018-09-10 |
| 1740797190 | Catelyn Schwerke | Social Worker | 3848 Maple Grove Dr, Apt 307, Madison, WI 53719 | 2018-01-08 |
| 1922519008 | Mary Jane Cruz Delorme | Registered Nurse | 6831 Mader Dr. #210, #210, Madison, WI 53719 | 2017-10-17 |
| Find all providers in zip 53719 | ||||
| Taxonomy Code | 106H00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Marriage & Family Therapist |
| A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700494473 | Kelsey Card | Marriage & Family Therapist | 702 N Blackhawk Ave Ste 215, Madison, WI 53705-3357 | 2020-07-20 |
| 1437773736 | Andrew Clayton | Marriage & Family Therapist | 440 Science Dr Ste 300, Madison, WI 53711-1064 | 2020-06-02 |
| 1518580638 | Caitlin Stark | Marriage & Family Therapist | 518 Algoma St, Madison, WI 53704-4813 | 2020-05-22 |
| 1144843772 | Sonya Sebren Summerlin | Marriage & Family Therapist | 17 Peachtree Ln, Madison, MS 39110-9217 | 2020-05-18 |
| 1083241723 | Tammey Rooney | Marriage & Family Therapist | 4 Grove Ave, Madison, CT 06443-3225 | 2020-03-24 |
| 1639702970 | Sheila Jane Mccabe | Marriage & Family Therapist | 1205 Saunders Ave, Madison, TN 37115-5118 | 2020-02-14 |
| 1881232189 | Redwood Family Therapy LLC | Marriage & Family Therapist | 6402 Odana Rd Ste 106, Madison, WI 53719-1123 | 2019-12-17 |
| 1932744067 | Sara Ruiz | Marriage & Family Therapist | Clock Tower Office Park, 6333 Odana Rd, #20, Madison, WI 53719 | 2019-11-13 |
| 1457993057 | Joseph Stephen Leonard | Marriage & Family Therapist | 8025 Excelsior Dr Ste 110, Madison, WI 53717-2902 | 2019-10-15 |
| 1912552878 | Heart Consulting LLC | Marriage & Family Therapist | 4706 Cottage Grove Rd Ste 300, Madison, WI 53716-1354 | 2019-08-07 |
| Find all providers in MADISON | ||||
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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.