SPIRITED PSYCHOLOGICAL SERVICES LLC (NPI# 1780234955) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780234955 |
| Entity Type | Organization |
| Organization Name | SPIRITED PSYCHOLOGICAL SERVICES LLC |
| Practice Address |
376 Violet Cir Grantsburg WI 54840-8564 |
| Mailing Address |
Po Box 502 Grantsburg WI 54840-0502 |
| Practice Telephone | 6126008431 |
| Mailing Telephone | 6126008431 |
| Enumeration Date | 2019-09-18 |
| Last Update Date | 2019-09-18 |
| Authorized Official Name | DR. CLARENCE LEONARD BONANDER JR. (OWNER) |
| Authorized Official Telephone | 6126008431 |
| Authorized Official Credential | LP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251S00000X | Community/Behavioral Health | Agencies | ||
| N | 305S00000X | Point of Service | Managed Care Organizations | ||
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| Street Address |
376 VIOLET CIR |
| City | GRANTSBURG |
| State | WI |
| Zip Code | 54840-8564 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679886618 | Maria Javaid | Internal Medicine | Shalamar Link Road, Lahore, Pakistan, Shalamar Institute of Health Sciences, Lahore, PUNJAB 54840 | 2010-07-20 |
| 1508949082 | Gary L Kaefer Dds Sc | Dentist | 302 South Pine St, Grantsburg, WI 54840 | 2006-10-20 |
| 1275544967 | Christopher John Witzany | Pharmacist | 122 W. Madison Ave., Grantsburg, WI 54840 | 2006-08-10 |
| 1841613619 | Christina Lachae Markovitz | Nurse Practitioner | 257 W Saint George Ave, Grantsburg, WI 54840 | 2014-01-29 |
| 1932141157 | David A Lang | Family Medicine | 257 W Saint George Ave, Grantsburg, WI 54840 | 2006-06-12 |
| 1790745446 | Richard Wayne Burris | Physician Assistant | 257 W Saint George Ave, Grantsburg, WI 54840 | 2006-03-26 |
| 1821425927 | Nancy Yvette Longhenry | Registered Nurse | 134 W Madison Ave, Grantsburg, WI 54840-7022 | 2013-10-03 |
| 1639174980 | Bellicose International Inc. | Durable Medical Equipment & Medical Supplies | 122 W Madison Ave, Grantsburg, WI 54840-7022 | 2005-06-14 |
| 1528625985 | Bellicose International Inc. | Pharmacy | 122 W Madison Ave, Grantsburg, WI 54840-7022 | 2019-05-21 |
| 1407365166 | Taylor James Paap | Pharmacist | 122 W Madison Ave, Grantsburg, WI 54840-7022 | 2017-09-26 |
| Find all providers in zip 54840 | ||||
| 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 |
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| 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 | GRANTSBURG |
| Zip Code | 54840 |
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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.