| Our Generations Inc. | |
|
1955 W. Broadway Ste 104 Monona WI 53713-1603 | |
| (608) 405-3002 | |
| (608) 405-5107 |
| Full Name | Our Generations Inc. |
|---|---|
| Speciality | Counselor |
| Location | 1955 W. Broadway Ste 104, Monona, Wisconsin |
| Authorized Official Name and Position | Ruchita Ervin (OWNER/CEO) |
| Authorized Official Contact | 6082016964 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Our Generations Inc. 1955 W. Broadway Ste 104 Monona WI 53713-1603 Ph: (608) 405-3002 | Our Generations Inc. 1955 W. Broadway Ste 104 Monona WI 53713-1603 Ph: (608) 405-3002 |
| NPI Number | 1609520204 |
|---|---|
| Provider Enumeration Date | 02/11/2022 |
| Last Update Date | 02/15/2022 |
| Certification Date | 02/15/2022 |
| Medicare PECOS PAC ID | 5294254363 |
|---|---|
| Medicare Enrollment ID | O20250522000781 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609520204 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Secondary |
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Ruchita Ervin |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1063891992 PECOS PAC ID: 0547789612 Enrollment ID: I20250522000849 |
| Provider Name | Brock Schultz |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1902552417 PECOS PAC ID: 5991214223 Enrollment ID: I20250529003581 |
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