Mr Michael R Nicholson, CSAC CSIT | |
10940 W Forest Home Ave, Hales Corners, WI 53130-2516 | |
(262) 278-4462 | |
(815) 387-2569 |
Full Name | Mr Michael R Nicholson |
---|---|
Gender | Male |
Speciality | Counselor - Addiction (substance Use Disorder) |
Location | 10940 W Forest Home Ave, Hales Corners, Wisconsin |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1619101847 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YA0400X | Counselor - Addiction (substance Use Disorder) | 15466-132 (Wisconsin) | Primary |
Entity Name | Red Oak Counseling Ltd |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1609890391 PECOS PAC ID: 5294704334 Enrollment ID: O20040927000490 |
Mailing Address | Practice Location Address |
---|---|
Mr Michael R Nicholson, CSAC CSIT 1021 N Mulford Rd, Rockford, IL 61107-3877 Ph: (815) 391-5600 | Mr Michael R Nicholson, CSAC CSIT 10940 W Forest Home Ave, Hales Corners, WI 53130-2516 Ph: (262) 278-4462 |
Brianna N Kirnbauer, B.A PSYCHOLOGY Counselor Medicare: Not Enrolled in Medicare Practice Location: 5250 S 108th St, Hales Corners, WI 53130 Phone: 414-296-1730 | |
Mrs. Barbara Josephine Baer, MA LMFT LPC LCSW Counselor Medicare: Medicare Enrolled Practice Location: 5300 S 108th St, Recovery Point Sc Suite 12b, Hales Corners, WI 53130 Phone: 414-529-2591 Fax: 414-529-2669 | |
Demitra Hahnfeld, MS, LPC, CRC Counselor Medicare: Not Enrolled in Medicare Practice Location: 10185 W Plum Tree Cir Apt 205, Hales Corners, WI 53130 Phone: 414-378-2077 | |
Sandra M Vandomelen, SAC-IT Counselor Medicare: Not Enrolled in Medicare Practice Location: 9415 W Forest Home Ave, Suite #1, Hales Corners, WI 53130 Phone: 414-427-4884 | |
Andrew Moon, APSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 10940 W Forest Home Ave, Hales Corners, WI 53130 Phone: 262-278-4462 Fax: 815-387-2569 | |
Marianne Faith Skrobiak, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 5300 S 108th St, Suite 12b, Hales Corners, WI 53130 Phone: 414-529-2591 Fax: 414-529-2669 | |
Lawrence Vernon Dulek, RADC I Counselor Medicare: Not Enrolled in Medicare Practice Location: 9415 West Forest Home Avenue, Suite #108, Hales Corners, WI 53130 Phone: 414-427-4884 Fax: 414-427-4889 |