| Jb Behavioral Health, Llc | |
|
301 N Broadway Ste 110 De Pere WI 54115-2571 | |
| (920) 425-4900 | |
| (920) 425-4200 |
| Full Name | Jb Behavioral Health, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 301 N Broadway Ste 110, De Pere, Wisconsin |
| Authorized Official Name and Position | Justine M. Garbaciak (OWNER/CLINICAL DIRECTOR) |
| Authorized Official Contact | 9206391032 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jb Behavioral Health, Llc 301 N Broadway Ste 110 De Pere WI 54115-2571 Ph: (920) 425-4900 | Jb Behavioral Health, Llc 301 N Broadway Ste 110 De Pere WI 54115-2571 Ph: (920) 425-4900 |
| NPI Number | 1164148847 |
|---|---|
| Provider Enumeration Date | 10/14/2022 |
| Last Update Date | 12/24/2022 |
| Certification Date | 12/24/2022 |
| Medicare PECOS PAC ID | 7113390972 |
|---|---|
| Medicare Enrollment ID | O20230227002427 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164148847 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Secondary |
| Provider Name | Michael H Winius |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346393287 PECOS PAC ID: 1951448653 Enrollment ID: I20091029000318 |
| Provider Name | Valerie A Hamilton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881747004 PECOS PAC ID: 0749262566 Enrollment ID: I20120509000609 |
| Provider Name | Steven P Kaplan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1548313869 PECOS PAC ID: 5395727119 Enrollment ID: I20130423000455 |
| Provider Name | Bonnie Mae Lee |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144310194 PECOS PAC ID: 6709295645 Enrollment ID: I20210506000745 |
| Provider Name | Megan A Kaye |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1457671638 PECOS PAC ID: 8628414992 Enrollment ID: I20240308000916 |
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