Marjorie Y Mendoza, LPC | |
800 Wisconsin Ave, Racine, WI 53403-1526 | |
(262) 637-8888 | |
(262) 637-0695 |
Full Name | Marjorie Y Mendoza |
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Gender | Female |
Speciality | Counselor - Professional |
Location | 800 Wisconsin Ave, Racine, Wisconsin |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1124324090 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | 2713-226 (Wisconsin) | Primary |
101YA0400X | Counselor - Addiction (substance Use Disorder) | 15596-131 (Wisconsin) | Secondary |
Entity Name | Professional Services Group Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1619024262 PECOS PAC ID: 8224296454 Enrollment ID: O20120220000742 |
Mailing Address | Practice Location Address |
---|---|
Marjorie Y Mendoza, LPC 8321 S 100th St, Franklin, WI 53132-2409 Ph: (414) 719-0076 | Marjorie Y Mendoza, LPC 800 Wisconsin Ave, Racine, WI 53403-1526 Ph: (262) 637-8888 |
Kathleen Rasmussen, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1320 Wisconsin Ave, Racine, WI 53403 Phone: 262-687-2222 | |
Sammy Joe Rangel, CSAC Counselor Medicare: Not Enrolled in Medicare Practice Location: 840 Lake Ave, 101, Racine, WI 53403 Phone: 262-634-8688 Fax: 262-634-7547 | |
Merritt Adams, CADCIII Counselor Medicare: Not Enrolled in Medicare Practice Location: 1717 Taylor Ave, Racine, WI 53403 Phone: 262-632-1780 Fax: 262-632-0895 | |
Dr. Kelly Jean Smith, PH.D., LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1717 Taylor Ave, Racine, WI 53403 Phone: 262-638-6771 | |
Donna R. Swanson, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 521 Sixth St, Racine, WI 53403 Phone: 262-898-2940 Fax: 262-898-1772 | |
Ms. Laura Ramos, Counselor Medicare: Not Enrolled in Medicare Practice Location: 800 Wisconsin Ave, Racine, WI 53403 Phone: 262-637-8888 Fax: 262-637-0695 | |
Mrs. Maryellen L. Schemel, MHP Counselor Medicare: Not Enrolled in Medicare Practice Location: 2405 Northwestern Ave, Suite Ll5, Racine, WI 53404 Phone: 262-260-8370 |