| Ccp Clinic, LLC | |
|
3301 Packerland Dr Ste B De Pere WI 54115-9533 | |
| (920) 234-9240 | |
| Not Available |
| Full Name | Ccp Clinic, LLC |
|---|---|
| Speciality | Psychologist |
| Location | 3301 Packerland Dr Ste B, De Pere, Wisconsin |
| Authorized Official Name and Position | Jaclyn Geitner (CO-OWNER) |
| Authorized Official Contact | 6514911346 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ccp Clinic, LLC 3301 Packerland Dr Ste B De Pere WI 54115-9533 Ph: (651) 491-1346 | Ccp Clinic, LLC 3301 Packerland Dr Ste B De Pere WI 54115-9533 Ph: (920) 234-9240 |
| NPI Number | 1396431714 |
|---|---|
| Provider Enumeration Date | 04/18/2023 |
| Last Update Date | 04/03/2025 |
| Certification Date | 03/29/2025 |
| Medicare PECOS PAC ID | 7214394022 |
|---|---|
| Medicare Enrollment ID | O20230609002780 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396431714 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | () | Secondary |
| 103TC0700X | Psychologist - Clinical | () | Primary |
| 1041C0700X | Social Worker - Clinical | () | Secondary |
| Provider Name | Breyan Donath-skeen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689004830 PECOS PAC ID: 6305073123 Enrollment ID: I20131224000120 |
| Provider Name | Dylan Patrick Murray |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629336730 PECOS PAC ID: 4486894573 Enrollment ID: I20160722000681 |
| Provider Name | Jaclyn Nina Geitner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629352844 PECOS PAC ID: 9638432560 Enrollment ID: I20180406000635 |
| Provider Name | Joseph L Torres |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649728890 PECOS PAC ID: 6204170368 Enrollment ID: I20181130002117 |
| Provider Name | Ellen Marie Meier-licht |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1518529718 PECOS PAC ID: 6901137660 Enrollment ID: I20191010000149 |
| Provider Name | Megan Doxtator |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447809561 PECOS PAC ID: 7214361526 Enrollment ID: I20200326001206 |
| Provider Name | Shannon L Gilson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477052579 PECOS PAC ID: 9335551860 Enrollment ID: I20230103001856 |
| Provider Name | Victoria Klieforth |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174279129 PECOS PAC ID: 2466809710 Enrollment ID: I20231108003440 |
| Provider Name | Kendra E Wuest |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922716927 PECOS PAC ID: 2668820937 Enrollment ID: I20231127002622 |
| Provider Name | Franchesca Carley Vasquez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730821364 PECOS PAC ID: 8426406406 Enrollment ID: I20231201000583 |
| Provider Name | Neeley K Welch-lamers |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1629322730 PECOS PAC ID: 9032576848 Enrollment ID: I20240209000356 |
| Provider Name | Kayla Bigelbach |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558148650 PECOS PAC ID: 2668992769 Enrollment ID: I20250219003022 |
| Provider Name | Elizabeth a Specht |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255850483 PECOS PAC ID: 6204359367 Enrollment ID: I20250328002807 |
| Provider Name | Kristi Anne Irving |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1699319160 PECOS PAC ID: 4385169101 Enrollment ID: I20250415000557 |
| Provider Name | Katie L Skebba |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558816173 PECOS PAC ID: 8325567605 Enrollment ID: I20250529002539 |
| Provider Name | Nicole a Lemerond |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1114447414 PECOS PAC ID: 5698280899 Enrollment ID: I20250716001764 |
| Provider Name | Angela Gardebrecht |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1730559451 PECOS PAC ID: 2264948439 Enrollment ID: I20250723003019 |
| Provider Name | Lisa a Hidde |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1467688648 PECOS PAC ID: 3072014604 Enrollment ID: I20250827001024 |
| Provider Name | Cindy Halford |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1811334840 PECOS PAC ID: 5799272290 Enrollment ID: I20251017000451 |
| Provider Name | Emily Ann O'connor |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1427558279 PECOS PAC ID: 4385133586 Enrollment ID: I20251028004267 |
| Provider Name | Michelle Swenson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1447633193 PECOS PAC ID: 5991297988 Enrollment ID: I20251126001499 |
| Provider Name | Allie Hurrish |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1164239281 PECOS PAC ID: 4981185147 Enrollment ID: I20260225002802 |
| Provider Name | Chloe J Kierszh |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1740796390 PECOS PAC ID: 7315420205 Enrollment ID: I20260310000683 |
| Provider Name | Emily J Bell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1275233587 PECOS PAC ID: 4082189915 Enrollment ID: I20260408003509 |
| Provider Name | Jenna M Belongia |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1922608132 PECOS PAC ID: 1850860578 Enrollment ID: I20260512002008 |
| Provider Name | Luci M Laluzerne |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1851810568 PECOS PAC ID: 6103395306 Enrollment ID: I20260518001074 |
| Provider Name | Jennifer Marie Dudek |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1013375419 PECOS PAC ID: 7214473024 Enrollment ID: I20260522002309 |
| Provider Name | Angie Schneider |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1497124226 PECOS PAC ID: 2567932965 Enrollment ID: I20260527002087 |
| Provider Name | Emily Belongia |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1164133781 PECOS PAC ID: 1456823178 Enrollment ID: I20260615000330 |
The Att Center Ltd Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3311 Packerland Dr Ste A10, De Pere, WI 54115 Phone: 920-264-0996 Fax: 920-932-3114 |
The Light Within Therapy LLC Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3311 So. Packerland Drive, Suite A#7, De Pere, WI 54115 Phone: 920-696-8288 |
Optum Behavioral Care of Colorado, P.C. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2071 Lawrence Dr Ste A, De Pere, WI 54115 Phone: 920-632-4471 |
Bellin Behavior Health-east Depere Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 555 Redbird Cir, De Pere, WI 54115 Phone: 920-338-6830 |
Riverside Psychiatric Group SC Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1325 Angels Path Rd, De Pere, WI 54115 Phone: 920-338-2855 Fax: 920-338-9270 |
JB Behavioral Health, LLC Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 301 N Broadway Ste 110, De Pere, WI 54115 Phone: 920-425-4900 Fax: 920-425-4200 |