| Greyley Wellness Llc | |
|
2010 Eastwood Dr Ste 300 Madison WI 53704-5387 | |
| (608) 509-9287 | |
| (608) 630-8089 |
| Full Name | Greyley Wellness Llc |
|---|---|
| Speciality | Counselor |
| Location | 2010 Eastwood Dr Ste 300, Madison, Wisconsin |
| Authorized Official Name and Position | Nicole E Moll (OWNER) |
| Authorized Official Contact | 6084196103 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Greyley Wellness Llc 2010 Eastwood Dr Ste 300 Madison WI 53704-5387 Ph: (608) 509-9287 | Greyley Wellness Llc 2010 Eastwood Dr Ste 300 Madison WI 53704-5387 Ph: (608) 509-9287 |
| NPI Number | 1093256604 |
|---|---|
| Provider Enumeration Date | 03/15/2017 |
| Last Update Date | 12/04/2023 |
| Certification Date | 12/04/2023 |
| Medicare PECOS PAC ID | 2860823036 |
|---|---|
| Medicare Enrollment ID | O20200504002365 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093256604 | NPI | - | NPPES |
| 100176083 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Aimee M Metzger |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174000764 PECOS PAC ID: 6406109271 Enrollment ID: I20181024001119 |
| Provider Name | Haley Brieanna Ostrander |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720646870 PECOS PAC ID: 9739571290 Enrollment ID: I20220113002485 |
| Provider Name | Sawyer E Smith |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1871109702 PECOS PAC ID: 6901258524 Enrollment ID: I20240119001119 |
| Provider Name | Nicole E Moll |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1578239851 PECOS PAC ID: 4587019997 Enrollment ID: I20240119002484 |
| Provider Name | Claudia Sue Schmidt |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1356816797 PECOS PAC ID: 1658724620 Enrollment ID: I20240125002686 |
| Provider Name | Shannon Monson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1457081812 PECOS PAC ID: 6800249756 Enrollment ID: I20240127000643 |
| Provider Name | Donald Bialkowski |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1699075903 PECOS PAC ID: 4688017445 Enrollment ID: I20240208001783 |
| Provider Name | Brooke K Villella |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1386388023 PECOS PAC ID: 1355784125 Enrollment ID: I20240208001946 |
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