| Nichole Decorah, LPC-IT | |
|
1508 New Pinery Rd, Portage, WI 53901-1312 | |
| (608) 745-4900 | |
| Not Available |
| Full Name | Nichole Decorah |
|---|---|
| Gender | Female |
| Speciality | Mental Health Counselor |
| Experience | 4 Years |
| Location | 1508 New Pinery Rd, Portage, 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 |
|---|---|---|---|
| 1154894848 | NPI | - | NPPES |
| 1154894848 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 5176-226 (Wisconsin) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Dean Health Systems Inc | 7012827983 | 1099 |
| Entity Name | Dean Health Systems Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1053358846 PECOS PAC ID: 7012827983 Enrollment ID: O20031105000584 |
| Mailing Address | Practice Location Address |
|---|---|
| Nichole Decorah, LPC-IT 532 Laurel St, Reedsburg, WI 53959-1231 Ph: (608) 566-5187 | Nichole Decorah, LPC-IT 1508 New Pinery Rd, Portage, WI 53901-1312 Ph: (608) 745-4900 |
Mrs. Heather Jane Gove, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 2639 New Pinery Rd # 1, Portage, WI 53901 Phone: 608-742-5020 | |
Shaun Alexander Hardie, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2639 New Pinery Rd Ste 1, Portage, WI 53901 Phone: 608-742-5020 Fax: 608-742-7011 | |
Melissa Trago, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1508 New Pinery Rd, Portage, WI 53901 Phone: 608-745-4900 | |
Robin A Deethardt, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 2901 Hunters Trl, Portage, WI 53901 Phone: 608-742-5518 Fax: 608-742-4087 | |
Susan A Knower, LPC, IDPAT Counselor Medicare: Not Enrolled in Medicare Practice Location: 2901 Hunters Trl, Portage, WI 53901 Phone: 608-742-5518 Fax: 608-742-4087 | |
Sarah J Kravick, LMFT Counselor Medicare: Medicare Enrolled Practice Location: 2639 New Pinery Rd, Suite 1, Portage, WI 53901 Phone: 608-742-5020 Fax: 608-742-3641 | |
Kristine G Schmitt, MA, LPC Counselor Medicare: Accepting Medicare Assignments Practice Location: 2901 Hunters Trl, Portage, WI 53901 Phone: 608-742-5518 |