| Community Service Associates, Sc | |
|
2901 Hunters Trl Portage WI 53901-3403 | |
| (608) 742-5518 | |
| (608) 742-4087 |
| Full Name | Community Service Associates, Sc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2901 Hunters Trl, Portage, Wisconsin |
| Authorized Official Name and Position | Sherry D Stevens (CREDENTIALING DEPT/BUSINESS MANAGER) |
| Authorized Official Contact | 6087425518 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Service Associates, Sc Po Box 301 2901 Hunters Trail Portage WI 53901-3403 Ph: (608) 742-5518 | Community Service Associates, Sc 2901 Hunters Trl Portage WI 53901-3403 Ph: (608) 742-5518 |
| NPI Number | 1780610923 |
|---|---|
| Provider Enumeration Date | 06/22/2006 |
| Last Update Date | 07/25/2024 |
| Certification Date | 07/25/2024 |
| Medicare PECOS PAC ID | 8426948746 |
|---|---|
| Medicare Enrollment ID | O20040318001251 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780610923 | NPI | - | NPPES |
| CD8222 | Other | WI | RAILROAD MEDICARE |
| W010102 | Other | WI | TRICARE/CHAMPUS |
| 292394 | Other | WI | VALUE OPTIONS |
| 501113 | Other | WI | DEAN HEALTH PLAN |
| Provider Name | Thomas J Hayes |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1528001450 PECOS PAC ID: 9830185032 Enrollment ID: I20040422001350 |
| Provider Name | Jocelyn R Miller |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1952345480 PECOS PAC ID: 0648284562 Enrollment ID: I20060131000384 |
| Provider Name | Adrea H Mcglynn |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1770840118 PECOS PAC ID: 9032373493 Enrollment ID: I20120614000578 |
| Provider Name | Lesley Baird Chapin |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1457575524 PECOS PAC ID: 8729230743 Enrollment ID: I20121219000578 |
| Provider Name | Jennifer L Cummings |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154591626 PECOS PAC ID: 7719119205 Enrollment ID: I20140416000603 |
| Provider Name | Lisa M Dunham |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346590452 PECOS PAC ID: 1254650252 Enrollment ID: I20150424000228 |
| Provider Name | Eric T Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417276031 PECOS PAC ID: 1456656842 Enrollment ID: I20160223001262 |
| Provider Name | Lisa A Mowbray |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205852886 PECOS PAC ID: 5496054561 Enrollment ID: I20160425002020 |
| Provider Name | Linda Stollfus |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871968222 PECOS PAC ID: 4284904301 Enrollment ID: I20170724001282 |
| Provider Name | Kym A Pharo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467976357 PECOS PAC ID: 2264799386 Enrollment ID: I20171128002396 |
| Provider Name | Christine M Preston |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104248160 PECOS PAC ID: 4385999580 Enrollment ID: I20180612000683 |
| Provider Name | Cynthia Joan Jurishica |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396222345 PECOS PAC ID: 7214289537 Enrollment ID: I20181015000477 |
| Provider Name | Jill D Dickson-baures |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1700287216 PECOS PAC ID: 3072948371 Enrollment ID: I20200114003500 |
| Provider Name | Rene L Buenzow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548214810 PECOS PAC ID: 3274566187 Enrollment ID: I20200818001250 |
| Provider Name | Kimberly Crowell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992301683 PECOS PAC ID: 7113330754 Enrollment ID: I20201229000045 |
| Provider Name | Valerie M Gonsalves |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1558918607 PECOS PAC ID: 4587056627 Enrollment ID: I20220121001029 |
| Provider Name | Christelle Carol Holder |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821777616 PECOS PAC ID: 3870949910 Enrollment ID: I20231026001534 |
| Provider Name | Whitney M Nelson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881367738 PECOS PAC ID: 2860840568 Enrollment ID: I20231117002607 |
| Provider Name | Jonathan J Schulz |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1770512782 PECOS PAC ID: 1153771068 Enrollment ID: I20231219000491 |
| Provider Name | Lynn L Hoornstra |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1932372612 PECOS PAC ID: 6901256833 Enrollment ID: I20231219001092 |
| Provider Name | Colleen L Jarema |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1245894765 PECOS PAC ID: 2365892247 Enrollment ID: I20231219003251 |
| Provider Name | Beth Fox Warnecke |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1326340233 PECOS PAC ID: 8527418300 Enrollment ID: I20231219003373 |
| Provider Name | Brittany Marie Hayes |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1720610454 PECOS PAC ID: 1759731573 Enrollment ID: I20231220000714 |
| Provider Name | Renee E Birkholz |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1467826990 PECOS PAC ID: 9537519236 Enrollment ID: I20231221000083 |
| Provider Name | Penny L Raimer |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1629046511 PECOS PAC ID: 3375993090 Enrollment ID: I20231221000842 |
| Provider Name | Heather Nh Simonson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1154419976 PECOS PAC ID: 9436104221 Enrollment ID: I20231222002646 |
| Provider Name | Jocelyn H Marks |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1861160954 PECOS PAC ID: 2264882612 Enrollment ID: I20231227000995 |
| Provider Name | Emily M Campbell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1174072284 PECOS PAC ID: 9638529092 Enrollment ID: I20231227001336 |
| Provider Name | Stephanie Lynn White Eagle |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1184957334 PECOS PAC ID: 9830532720 Enrollment ID: I20240207003295 |
| Provider Name | Lori A Cornell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1376052035 PECOS PAC ID: 1658728597 Enrollment ID: I20240219003173 |
| Provider Name | Jacqueline J Baures |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1508501131 PECOS PAC ID: 2163963927 Enrollment ID: I20240919002321 |
| Provider Name | Sandra J Reinardy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619608726 PECOS PAC ID: 1052834272 Enrollment ID: I20250328001284 |
| Provider Name | Daelynn M Phares |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1689495095 PECOS PAC ID: 1557884392 Enrollment ID: I20250402000699 |
| Provider Name | Alexander B Mentzel |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1205529914 PECOS PAC ID: 2365966751 Enrollment ID: I20250407003095 |
Compass Counseling, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1508 New Pinery Rd, Portage, WI 53901 Phone: 608-745-4900 Fax: 608-745-4990 | |
Journey Mental Health Center, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1440 E Wisconsin St, Portage, WI 53901 Phone: 608-280-2700 | |
Mary Ellen Miller, Ms, Lpc, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: W10445 State Road 16 Lot 21, Portage, WI 53901 Phone: 608-617-8419 | |
Columbia County Hhsd Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 111 E Mullett St, Portage, WI 53901 Phone: 608-742-9227 Fax: 608-742-9700 | |
Aspen Family Counseling Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 2639 New Pinery Rd, Suite 1, Portage, WI 53901 Phone: 608-742-5020 Fax: 608-742-3641 | |
Columbia County Hhsd Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 111 E Mullett St, Portage, WI 53901 Phone: 608-742-9227 Fax: 608-742-9700 | |
Columbia County Hhsd Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 111 E Mullett St, Portage, WI 53901 Phone: 608-742-9227 Fax: 608-742-9700 |