MOONTREE PSYCHOTHERAPY CENTER LLC (NPI# 1770806259) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770806259 |
| Entity Type | Organization |
| Organization Name | MOONTREE PSYCHOTHERAPY CENTER LLC |
| Practice Address |
401 Wisconsin Ave Madison WI 53703-1487 |
| Practice Telephone | 6082565115 |
| Practice Fax Number | 6082565116 |
| Mailing Telephone | 6082565115 |
| Mailing Fax Number | 6082565116 |
| Enumeration Date | 2010-03-11 |
| Last Update Date | 2010-03-11 |
| Authorized Official Name | DALE DECKER (MEMBER) |
| Authorized Official Telephone | 6082565115 |
| Authorized Official Credential | LCSW |
| 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) |
1916 | WI | Ambulatory Health Care Facilities |
| Street Address |
401 WISCONSIN AVE |
| City | MADISON |
| State | WI |
| Zip Code | 53703-1487 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659452571 | Holly Jorgenson | Counselor | 401 Wisconsin Ave, Suite 100, Madison, WI 53703-1487 | 2006-10-18 |
| 1245895754 | Mind Evolution | Social Worker | 401 Wisconsin Ave, Madison, WI 53703-1487 | 2019-05-09 |
| 1144708942 | Nickles Counseling, LLC | Social Worker | 401 Wisconsin Ave, Madison, WI 53703-1487 | 2018-08-02 |
| 1609362268 | Abbey Scherer, L.L.C. | Counselor | 401 Wisconsin Ave, Madison, WI 53703-1487 | 2018-07-06 |
| 1780138776 | Carol Nickles | Social Worker | 401 Wisconsin Ave, Madison, WI 53703-1487 | 2016-08-08 |
| 1952767659 | Laura Ruskaup | Counselor | 401 Wisconsin Ave, Madison, WI 53703-1487 | 2016-01-11 |
| 1861803512 | Interpersonnel | Counselor | 401 Wisconsin Ave, Madison, WI 53703-1487 | 2014-05-15 |
| 1649607821 | Amy Christine Ginko | Counselor | 401 Wisconsin Ave, Madison, WI 53703-1487 | 2013-10-02 |
| 1942555321 | Elizabeth Maureen Reeder | Marriage & Family Therapist | 401 Wisconsin Ave, Madison, WI 53703-1487 | 2012-07-20 |
| 1720346786 | Rachele Klassy | Social Worker | 401 Wisconsin Ave, Madison, WI 53703-1487 | 2012-04-27 |
| Find all providers in the same location | ||||
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|---|---|---|---|---|
| 1689291254 | Lynne's Moc, LLC | Optometrist | 512 State Street, Madison, WI 53703 | 2020-06-30 |
| 1407327844 | Deborah Ann Pape | Psychologist | 350 S. Hamilton St., Unit 504, Madison, WI 53703 | 2018-12-11 |
| 1336660216 | Kevin Shuai Lian | Radiology | 420 W Dayton St Unit 1142, Madison, WI 53703 | 2017-06-30 |
| 1295279461 | Colin T Graney | Podiatrist | 664 W. Washington Ave, Madison, WI 53703 | 2016-12-07 |
| 1093193690 | Ashley Przybilla | Pediatrics | Group Health Cooperative of South Central Wisconsin, 675 West Washington Avenue, Madison, WI 53703 | 2015-05-14 |
| 1043606841 | Kevin P Emmerich | Emergency Medicine | 390 West Johnson St, Madison, WI 53703 | 2015-04-09 |
| 1376983155 | Ann Renee Wingate | Counselor | 16 N. Hancock Street, Hancock Center, Madison, WI 53703 | 2013-06-26 |
| 1013269398 | See Inc | Optometrist | 437 State St, Madison, WI 53703 | 2012-10-10 |
| 1518243237 | Nathan Dufault | Specialist/Technologist | 305 S. Livingston St., Madison, WI 53703 | 2011-10-26 |
| 1518264142 | Candice Y Lewis | Health Maintenance Organization | 675 W.washington Ave. Group Health Cooperative of South, Madison, WI 53703 | 2011-02-17 |
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| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
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| 1023519956 | Strata Psychotherapy & Adhd Services, LLC | Clinic/Center | 6701 Seybold Rd Ste 114, Madison, WI 53719-1388 | 2018-02-26 |
| 1649785643 | Big Heart Counseling Center | Clinic/Center | 6409 Odana Rd Ste 24, Madison, WI 53719-1177 | 2017-12-12 |
| 1861921553 | Morristown Counseling Associates | Clinic/Center | 2 Green Village Rd Apt 203, Madison, NJ 07940-2581 | 2017-06-07 |
| 1689117202 | Dr Christine Foskett LLC | Clinic/Center | 7633 Ganser Way Ste 104, Madison, WI 53719-2092 | 2016-11-30 |
| 1881044162 | John Joseph Barisa | Clinic/Center | 209 Patricia Rd, Madison, AL 35758-1416 | 2016-06-16 |
| 1023261211 | The Family Resource Group | Clinic/Center | 313 Price Pl Ste 11, Madison, WI 53705-3250 | 2008-10-31 |
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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.