| Ms Pamela Jean Koonz, LCSW CSAC | |
|
4810 Northwestern Ave, Racine, WI 53406 | |
| (262) 637-9984 | |
| (262) 637-9995 |
| Full Name | Ms Pamela Jean Koonz |
|---|---|
| Gender | Female |
| Speciality | Clinical Social Worker |
| Experience | 41 Years |
| Location | 4810 Northwestern Ave, Racine, Wisconsin |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518006667 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 1298132 (Wisconsin) | Primary |
| 104100000X | Social Worker | 3908123 (Wisconsin) | Secondary |
| Entity Name | Lakeside Family Therapy Services Ltd |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1407998719 PECOS PAC ID: 3678756400 Enrollment ID: O20110331000546 |
| Mailing Address | Practice Location Address |
|---|---|
| Ms Pamela Jean Koonz, LCSW CSAC 5329 Deerfield Rd, Racine, WI 53406 Ph: () - | Ms Pamela Jean Koonz, LCSW CSAC 4810 Northwestern Ave, Racine, WI 53406 Ph: (262) 637-9984 |
Elmo G Painter-edington, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1545 Boyd Ave, Racine, WI 53405 Phone: 773-546-8028 | |
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, LPC Counselor Medicare: Accepting Medicare Assignments Practice Location: 800 Wisconsin Ave, Racine, WI 53403 Phone: 262-637-8888 Fax: 262-637-0695 |