| Mind Body Program LLC | |
|
199 County Road Df Fl 3 Juneau WI 53039-9512 | |
| (920) 386-4094 | |
| (920) 386-4564 |
| Full Name | Mind Body Program LLC |
|---|---|
| Speciality | Counselor |
| Location | 199 County Road Df Fl 3, Juneau, Wisconsin |
| Authorized Official Name and Position | Lauri Christine Gebhard (PSYCHOLOGIST) |
| Authorized Official Contact | 4148078934 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mind Body Program LLC 15300 Watertown Plank Rd Ste 106 Elm Grove WI 53122-2348 Ph: (414) 807-8934 | Mind Body Program LLC 199 County Road Df Fl 3 Juneau WI 53039-9512 Ph: (920) 386-4094 |
| NPI Number | 1205084118 |
|---|---|
| Provider Enumeration Date | 09/04/2008 |
| Last Update Date | 09/03/2025 |
| Certification Date | 09/03/2025 |
| Medicare PECOS PAC ID | 4183756877 |
|---|---|
| Medicare Enrollment ID | O20100715000508 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205084118 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | () | Primary |
| Provider Name | Lauri C Gebhard |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1538276720 PECOS PAC ID: 8022056894 Enrollment ID: I20050421000836 |
| Provider Name | Larisa Hutchins |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1841344256 PECOS PAC ID: 6608022637 Enrollment ID: I20160627002425 |
| Provider Name | Lyndsy Marie Mirasola |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053719138 PECOS PAC ID: 9739419987 Enrollment ID: I20231204001905 |
| Provider Name | Denise L Falaschi |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1700288420 PECOS PAC ID: 4789034505 Enrollment ID: I20231220000938 |
| Provider Name | Julie L Educate |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1134602733 PECOS PAC ID: 2961847918 Enrollment ID: I20240229000664 |
| Provider Name | Katrina Davis-hicks |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1861813420 PECOS PAC ID: 6204364672 Enrollment ID: I20250113002385 |
| Provider Name | Tyler Van Zeeland |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1053182287 PECOS PAC ID: 5193247427 Enrollment ID: I20250317001798 |
| Provider Name | Michael F Smith |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1477298768 PECOS PAC ID: 1850817990 Enrollment ID: I20250501000641 |
| Provider Name | Amanda Lee Westerlund |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1598508319 PECOS PAC ID: 1557834199 Enrollment ID: I20260624004232 |
Crisis Intervention Progam Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 199 County Road Df 3rd Floor, Juneau, WI 53032 Phone: 920-386-4094 Fax: 920-386-3812 |
Healing Relationships LLC Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 150 Miller St, Juneau, WI 53039 Phone: 920-214-3733 Fax: 920-267-4027 |
Dodge County Human Services Ccs Program Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 199 County Road Df 3rd Floor, Juneau, WI 53032 Phone: 920-386-4094 Fax: 920-386-3812 |
Dodge County Human Services Mental Health Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 199 County Road Df, 3rd Floor, Juneau, WI 53039 Phone: 920-386-3500 Fax: 920-386-4564 |