| Credence Therapy Associates Inc | |
|
1 1/2 W Geneva St Elkhorn WI 53121-1722 | |
| (262) 723-3424 | |
| (262) 723-8308 |
| Full Name | Credence Therapy Associates Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1 1/2 W Geneva St, Elkhorn, Wisconsin |
| Authorized Official Name and Position | Kim Ann Steen (DIRECTOR) |
| Authorized Official Contact | 2627233424 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Credence Therapy Associates Inc 1 1/2 W Geneva St Elkhorn WI 53121-1722 Ph: (262) 723-3424 | Credence Therapy Associates Inc 1 1/2 W Geneva St Elkhorn WI 53121-1722 Ph: (262) 723-3424 |
| NPI Number | 1487648663 |
|---|---|
| Provider Enumeration Date | 09/02/2005 |
| Last Update Date | 12/29/2014 |
| Medicare PECOS PAC ID | 6800838293 |
|---|---|
| Medicare Enrollment ID | O20050525001069 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487648663 | NPI | - | NPPES |
| 538578 | Other | WI | DEAN CARE |
| 17257700 | Other | MAGELLAN BEH HEALTH | |
| 42168400 | Other | CENPATICO | |
| 42168400 | Medicaid | WI | |
| 42169400 | Other | WI | HIRSP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 1262 (Wisconsin) | Primary |
| Provider Name | Kim A Steen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952395477 PECOS PAC ID: 0244308831 Enrollment ID: I20120227000741 |
| Provider Name | Sandra L Muetzel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407078835 PECOS PAC ID: 7618263757 Enrollment ID: I20160915001606 |
| Provider Name | George W Warren |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851793350 PECOS PAC ID: 1153681812 Enrollment ID: I20180129002053 |
| Provider Name | Kimberly A Anderberg |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598478000 PECOS PAC ID: 4385018159 Enrollment ID: I20230317000239 |
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