| Keith Knutson, | |
|
1220 Dewey Ave, Wauwatosa, WI 53213-2504 | |
| (414) 773-4312 | |
| (414) 454-6789 |
| Full Name | Keith Knutson |
|---|---|
| Gender | Male |
| Speciality | Mental Health Counselor |
| Experience | 9 Years |
| Location | 1220 Dewey Ave, Wauwatosa, Wisconsin |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205377447 | NPI | - | NPPES |
| 100096897 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 10407125 (Wisconsin) | Secondary |
| 101YM0800X | Counselor - Mental Health | 10407 (Wisconsin) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Aurora Medical Group, Inc. | 6709794258 | 3491 |
| Entity Name | Aurora Medical Group, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1427271378 PECOS PAC ID: 6709794258 Enrollment ID: O20031105000725 |
| Mailing Address | Practice Location Address |
|---|---|
| Keith Knutson, Po Box 735044, Chicago, IL 60673-5044 Ph: (800) 326-2250 | Keith Knutson, 1220 Dewey Ave, Wauwatosa, WI 53213-2504 Ph: (414) 773-4312 |
Dr. Tiffany Marie Prather, PSYD Counselor Medicare: Not Enrolled in Medicare Practice Location: 10045 W Lisbon Ave, Wauwatosa, WI 53222 Phone: 414-358-7999 Fax: 414-358-7158 | |
Sarah Schelble, Counselor Medicare: Not Enrolled in Medicare Practice Location: 7954 Harwood Ave Ste 40, Wauwatosa, WI 53213 Phone: 414-573-6891 | |
Lindsay Maruszewski, Counselor Medicare: Not Enrolled in Medicare Practice Location: 10425 W North Ave Ste 236, Wauwatosa, WI 53226 Phone: 414-509-0029 Fax: 414-296-8859 | |
Julia Kristin Crivello, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2222 N Mayfair Rd Ste 120, Wauwatosa, WI 53226 Phone: 414-939-9390 Fax: 414-939-9383 | |
Michael Richard Kiel, LPC-IT Counselor Medicare: Not Enrolled in Medicare Practice Location: 3636 N 124th St Ste 300, Wauwatosa, WI 53222 Phone: 414-476-9755 | |
Bao Yang, MSW, LCSW Counselor Medicare: Medicare Enrolled Practice Location: 11220 W Burleigh St Ste 100, Wauwatosa, WI 53222 Phone: 414-944-0021 | |
Daina L Westerman, LPC, CSAC Counselor Medicare: Medicare Enrolled Practice Location: 1220 Dewey Ave, Wauwatosa, WI 53213 Phone: 414-454-6539 Fax: 414-454-6688 |