| Racine Psychological Services, Inc. | |
|
840 Lake Ave Suite 101 Racine WI 53403-1566 | |
| (262) 634-8688 | |
| (262) 634-7547 |
| Full Name | Racine Psychological Services, Inc. |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 840 Lake Ave, Racine, Wisconsin |
| Authorized Official Name and Position | Mary Jane Whitmore (DIRECTOR) |
| Authorized Official Contact | 2626348688 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Racine Psychological Services, Inc. 840 Lake Ave Suite 101 Racine WI 53403-1566 Ph: (262) 634-8688 | Racine Psychological Services, Inc. 840 Lake Ave Suite 101 Racine WI 53403-1566 Ph: (262) 634-8688 |
| NPI Number | 1275586323 |
|---|---|
| Provider Enumeration Date | 05/18/2006 |
| Last Update Date | 04/20/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275586323 | NPI | - | NPPES |
| 42216900 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | 2220 (Wisconsin) | Primary |
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