| Kathleen Cook, | |
|
2639 New Pinery Rd Ste 1, Portage, WI 53901-1110 | |
| (608) 742-5020 | |
| (608) 742-3641 |
| Full Name | Kathleen Cook |
|---|---|
| Gender | Female |
| Speciality | Marriage And Family Therapist |
| Experience | 25 Years |
| Location | 2639 New Pinery Rd Ste 1, 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 |
|---|---|---|---|
| 1407951767 | NPI | - | NPPES |
| 40919600 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | 656-124 (Wisconsin) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Family Therapy Center Of Madison, Inc. | 1850285826 | 13 |
| Entity Name | Family Therapy Center Of Madison, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1164587150 PECOS PAC ID: 1850285826 Enrollment ID: O20040211000028 |
| Mailing Address | Practice Location Address |
|---|---|
| Kathleen Cook, 2639 New Pinery Rd Ste 1, Portage, WI 53901-1110 Ph: (608) 742-5020 | Kathleen Cook, 2639 New Pinery Rd Ste 1, Portage, WI 53901-1110 Ph: (608) 742-5020 |
Jennifer R Gruba, PHD Couples Therapy Medicare: May Accept Medicare Assignments Practice Location: 2901 Hunters Trl, Portage, WI 53901 Phone: 608-742-5518 Fax: 608-742-4087 | |
Ms. Rebecca Anna Kaiser, MS, LMFT Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 412 E Slifer Street, Po Box 445, Portage, WI 53901 Phone: 608-745-1751 Fax: 608-745-1757 | |
Erin Shawnna Grimm, MFT Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 317 Dewitt St, Portage, WI 53901 Phone: 608-745-1751 Fax: 608-745-1757 |