| Fond Du Lac County | |
|
459 E 1st St Fond Du Lac WI 54935-4505 | |
| (920) 929-3500 | |
| (920) 929-3129 |
| Full Name | Fond Du Lac County |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 459 E 1st St, Fond Du Lac, Wisconsin |
| Authorized Official Name and Position | J R Musunuru (DIRECTOR, PSYCHIATRIST) |
| Authorized Official Contact | 9209293500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fond Du Lac County 459 E 1st St Fond Du Lac WI 54935-4505 Ph: (920) 929-3500 | Fond Du Lac County 459 E 1st St Fond Du Lac WI 54935-4505 Ph: (920) 929-3500 |
| NPI Number | 1053458935 |
|---|---|
| Provider Enumeration Date | 01/31/2007 |
| Last Update Date | 01/18/2012 |
| Medicare PECOS PAC ID | 2668376245 |
|---|---|
| Medicare Enrollment ID | O20031125000279 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053458935 | NPI | - | NPPES |
| 42121200 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Everest C Brooks |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184631624 PECOS PAC ID: 1557442365 Enrollment ID: I20080118000138 |
| Provider Name | Espen Klausen |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1013100684 PECOS PAC ID: 0446398226 Enrollment ID: I20091116000512 |
| Provider Name | Joline M Brotzman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578813606 PECOS PAC ID: 3577714765 Enrollment ID: I20121116000243 |
| Provider Name | Khalid I Chaudhry |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1104921766 PECOS PAC ID: 9234021445 Enrollment ID: I20161229001269 |
| Provider Name | Brittany A Kornfehl |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619471117 PECOS PAC ID: 8325303076 Enrollment ID: I20180529003256 |
| Provider Name | Jamie Michelle Rambeau |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1649248923 PECOS PAC ID: 4981633641 Enrollment ID: I20191127000502 |
| Provider Name | Kurt P Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396399606 PECOS PAC ID: 8527428143 Enrollment ID: I20230714000661 |
| Provider Name | Sara F Aniceto |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1225668163 PECOS PAC ID: 3072958404 Enrollment ID: I20240304000382 |
| Provider Name | Eric J Pantojas |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1962071217 PECOS PAC ID: 3971941659 Enrollment ID: I20240401000262 |
| Provider Name | Karen N Rucks |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1336559863 PECOS PAC ID: 4082052717 Enrollment ID: I20240401001972 |
| Provider Name | Erin R Maguire |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770114050 PECOS PAC ID: 4789061094 Enrollment ID: I20240402001337 |
| Provider Name | Alleah M Pynenberg |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1669215257 PECOS PAC ID: 1951849579 Enrollment ID: I20240814002314 |
| Provider Name | Sandra M Schug |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1033824420 PECOS PAC ID: 1153766456 Enrollment ID: I20250325000902 |
Positive Clinical Concepts Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 498 Ruggles St, Fond Du Lac, WI 54935 Phone: 801-703-6192 | |
Transformative Connections Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 88 Guindon Blvd, Fond Du Lac, WI 54935 Phone: 920-318-3282 | |
Integrated Counseling Center Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: N6687 Wrightway Dr Ste D, Fond Du Lac, WI 54937 Phone: 920-929-9140 Fax: 920-929-9142 | |
Optum Behavioral Care Of Colorado, P.c. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 196 3rd St, Fond Du Lac, WI 54935 Phone: 920-733-2065 | |
Alicia Hans Lcsw Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 21 N Portland St Ste 2b, Fond Du Lac, WI 54935 Phone: 920-630-1324 Fax: 920-479-2870 | |
Wisconsin Lutheran Child & Family Service Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 757 S Main St, Suite 8, Fond Du Lac, WI 54935 Phone: 920-731-9798 Fax: 920-731-1097 |