| Ease Of Mind Mental Health Solution Llc | |
|
2976 Triverton Pike Dr # 225 Fitchburg WI 53711-5840 | |
| (608) 381-4976 | |
| (608) 284-7947 |
| Full Name | Ease Of Mind Mental Health Solution Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2976 Triverton Pike Dr # 225, Fitchburg, Wisconsin |
| Authorized Official Name and Position | Sadat Abiri (OWNER) |
| Authorized Official Contact | 6083814976 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ease Of Mind Mental Health Solution Llc 2976 Triverton Pike Dr Ste 225 Fitchburg WI 53711-5840 Ph: (608) 381-4976 | Ease Of Mind Mental Health Solution Llc 2976 Triverton Pike Dr # 225 Fitchburg WI 53711-5840 Ph: (608) 381-4976 |
| NPI Number | 1285227868 |
|---|---|
| Provider Enumeration Date | 02/15/2021 |
| Last Update Date | 08/07/2023 |
| Certification Date | 08/07/2023 |
| Medicare PECOS PAC ID | 3870993470 |
|---|---|
| Medicare Enrollment ID | O20210618002049 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285227868 | NPI | - | NPPES |
| 100044922 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Annette S Vonfrankenberg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235252339 PECOS PAC ID: 1254405236 Enrollment ID: I20080808000732 |
| Provider Name | Sadat Abiri |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609290949 PECOS PAC ID: 9335237304 Enrollment ID: I20150716000189 |
| Provider Name | Amanda Fox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962803023 PECOS PAC ID: 8527429802 Enrollment ID: I20230802003935 |
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