| Walworth County Department Of Health And Human Services | |
|
1910 County Road Nn Elkhorn WI 53121-4454 | |
| (262) 741-3200 | |
| (262) 741-3217 |
| Full Name | Walworth County Department Of Health And Human Services |
|---|---|
| Speciality | Clinic/Center |
| Location | 1910 County Road Nn, Elkhorn, Wisconsin |
| Authorized Official Name and Position | Carlo Jon Nevicosi (DIRECTOR) |
| Authorized Official Contact | 2627413200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Walworth County Department Of Health And Human Services Po Box 1005 Elkhorn WI 53121 Ph: (262) 741-3200 | Walworth County Department Of Health And Human Services 1910 County Road Nn Elkhorn WI 53121-4454 Ph: (262) 741-3200 |
| NPI Number | 1588733307 |
|---|---|
| Provider Enumeration Date | 11/07/2006 |
| Last Update Date | 08/28/2023 |
| Certification Date | 08/28/2023 |
| Medicare PECOS PAC ID | 6002872835 |
|---|---|
| Medicare Enrollment ID | O20041203000437 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588733307 | NPI | - | NPPES |
| 42124600 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Randall J Zblewski |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1154426617 PECOS PAC ID: 3274427794 Enrollment ID: I20040213000246 |
| Provider Name | Elaine M Sorem |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629167085 PECOS PAC ID: 8224036900 Enrollment ID: I20061113000031 |
| Provider Name | Kelly M Gustavson Mattek |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1750471314 PECOS PAC ID: 6901806769 Enrollment ID: I20070102000256 |
| Provider Name | Nicole E Heinrich |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447281779 PECOS PAC ID: 7517048200 Enrollment ID: I20080119000056 |
| Provider Name | Anna Nusbaum |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1396896445 PECOS PAC ID: 3375628274 Enrollment ID: I20080317000124 |
| Provider Name | Patric W Mattek |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1477540243 PECOS PAC ID: 3476690918 Enrollment ID: I20091102000329 |
| Provider Name | Kristi L Reynolds |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154558591 PECOS PAC ID: 9830374719 Enrollment ID: I20110420000293 |
| Provider Name | Christa B Pierce |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346591286 PECOS PAC ID: 4082846761 Enrollment ID: I20140411000102 |
| Provider Name | Kristi M Moriarity |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447642202 PECOS PAC ID: 2567781099 Enrollment ID: I20150506000037 |
| Provider Name | Lynda A Nelson Elmudesi |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821256561 PECOS PAC ID: 4880754514 Enrollment ID: I20180417000617 |
| Provider Name | Clayton Richard Peterson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912662008 PECOS PAC ID: 6002205754 Enrollment ID: I20211118000061 |
| Provider Name | Amy M Hart |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992206635 PECOS PAC ID: 1355710328 Enrollment ID: I20221214000253 |
| Provider Name | Sarah A Schmidt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740802230 PECOS PAC ID: 0648649434 Enrollment ID: I20221221000068 |
| Provider Name | Jessica M Shipman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1215308150 PECOS PAC ID: 6901254754 Enrollment ID: I20240311003607 |
Walworth County Department Of Health And Human Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1910 County Road Nn, Elkhorn, WI 53121 Phone: 262-741-3200 Fax: 262-741-3217 | |
Credence Therapy Associates Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1 1/2 W Geneva St, Elkhorn, WI 53121 Phone: 262-723-3424 Fax: 262-723-8308 | |
Walworth County Department Of Health And Human Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1910 County Road Nn, Elkhorn, WI 53121 Phone: 262-741-3200 Fax: 262-741-3217 | |
All Encompassing Counseling Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 209 O'connor Drive, Elkhorn, WI 53121 Phone: 262-374-5251 | |
Walworth County Department Of Health And Human Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1910 County Road Nn, Elkhorn, WI 53121 Phone: 262-741-3200 Fax: 262-741-3217 | |
Walworth County Department Of Health And Human Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1910 County Road Nn, Elkhorn, WI 53121 Phone: 262-741-3200 Fax: 262-741-3217 |