Madison Psychotherapy Center, Llc

LBN: Madison Psychotherapy Center, Llc
Madison Psychotherapy Center, Llc is an health care organization with primary practice located at 702 N Blackhawk Ave Suite 205, Madison WI 53705-3357. The organization recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Marriage & Family Therapist. Behavioral Health & Social Service Providers / Clinical is the primary health care specialty. Madison Psychotherapy Center, Llc can be contacted via phone (608) 233-3037, or through Miller, Mary Ellen via phone (608) 233-3037.

Contact Information

Primary practice address
702 N Blackhawk Ave Suite 205 Madison WI 53705-3357
Phone: (608) 233-3037
Fax: (608) 233-5893
Website:
Map and Directions
Authorized official contact:
Name: Miller, Mary Ellen Licensed Professional Counselor (LPC)
Phone: (608) 233-3037

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X
Behavioral Health & Social Service Providers / Clinical 1041C0700X
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X

Profile Details

NPI number 1902023435
LBN Legal business name Madison Psychotherapy Center, Llc
DBA Doing business as
Authorized official Miller, Mary Ellen Licensed Professional Counselor (LPC)
Entity Organization
Organization subpart 1 No
Enumeration date Apr 19th, 2007
Last updated Mar 5th, 2015 - about 9 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902023435 NPPES
Wisconsin MEDICAID 42177200

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