| Innovative Counseling Inc | |
|
1499 6th St Innovative Counseling Inc Green Bay WI 54304-2252 | |
| (920) 497-6161 | |
| (920) 498-0476 |
| Full Name | Innovative Counseling Inc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 1499 6th St, Green Bay, Wisconsin |
| Authorized Official Name and Position | Cynthia Rae Thomas (CLINICAL DIRECTOR) |
| Authorized Official Contact | 9204976161 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Innovative Counseling Inc 1499 6th St Innovative Counseling Inc Green Bay WI 54304-2252 Ph: (920) 497-6161 | Innovative Counseling Inc 1499 6th St Innovative Counseling Inc Green Bay WI 54304-2252 Ph: (920) 497-6161 |
| NPI Number | 1093869588 |
|---|---|
| Provider Enumeration Date | 01/22/2007 |
| Last Update Date | 03/15/2010 |
| Medicare PECOS PAC ID | 8022154749 |
|---|---|
| Medicare Enrollment ID | O20091012000203 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093869588 | NPI | - | NPPES |
| 42207500 | Medicaid | WI | |
| WI1391 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 2283 (Wisconsin) | Primary |
| Provider Name | Barbara D Meyer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831243328 PECOS PAC ID: 0547220592 Enrollment ID: I20041013001281 |
| Provider Name | Glenda A Mcconnell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316011653 PECOS PAC ID: 6800827494 Enrollment ID: I20070313000293 |
| Provider Name | Joseph Hoelscher |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033139837 PECOS PAC ID: 8123173754 Enrollment ID: I20090903000627 |
| Provider Name | James J Balza |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720242555 PECOS PAC ID: 1658417373 Enrollment ID: I20091012000216 |
| Provider Name | Cynthia Thomas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780868125 PECOS PAC ID: 3476699190 Enrollment ID: I20140723002716 |
| Provider Name | Allison E Pohlman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184922940 PECOS PAC ID: 9133340086 Enrollment ID: I20141020000134 |
| Provider Name | Rachael M Gilbertson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245570449 PECOS PAC ID: 0749595957 Enrollment ID: I20150818003853 |
| Provider Name | Donna Z Buechner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114317419 PECOS PAC ID: 4082924345 Enrollment ID: I20160301002427 |
| Provider Name | Paula Urcavich |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275072696 PECOS PAC ID: 0345585105 Enrollment ID: I20181224000055 |
| Provider Name | Nicole M Aman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699386367 PECOS PAC ID: 0648699900 Enrollment ID: I20201006001646 |
| Provider Name | Angela Quinn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467938811 PECOS PAC ID: 3971905779 Enrollment ID: I20210716000186 |
| Provider Name | Judy Treml |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881178085 PECOS PAC ID: 8527421940 Enrollment ID: I20230831002582 |
| Provider Name | Rachel Lannoye |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447886635 PECOS PAC ID: 9739542184 Enrollment ID: I20230831003821 |
| Provider Name | Alexandria Wendlandt |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1841642345 PECOS PAC ID: 8820435852 Enrollment ID: I20240326001474 |
| Provider Name | Rebecca Lou Rauens |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1164952933 PECOS PAC ID: 2062945652 Enrollment ID: I20241105000436 |
| Provider Name | Crystal Hooyman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356176812 PECOS PAC ID: 6002340569 Enrollment ID: I20241107000328 |
| Provider Name | Dan Rauens |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1871045526 PECOS PAC ID: 3779004817 Enrollment ID: I20250305003779 |
| Provider Name | Carolyn M Martin-johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396894259 PECOS PAC ID: 1658892567 Enrollment ID: I20250307002568 |
| Provider Name | Shannon M Anderson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053043398 PECOS PAC ID: 1951822519 Enrollment ID: I20250311003830 |
| Provider Name | Nicole Walch |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1821593153 PECOS PAC ID: 3870014384 Enrollment ID: I20250312002093 |
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