| Professional Services Group, Inc. | |
|
2108 63rd St Kenosha WI 53143-4454 | |
| (262) 652-2406 | |
| (262) 654-6960 |
| Full Name | Professional Services Group, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 2108 63rd St, Kenosha, Wisconsin |
| Authorized Official Name and Position | Jonathan Grapengieser (CLINICAL DIRECTOR) |
| Authorized Official Contact | 2626541004 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Professional Services Group, Inc. 6233 39th Ave Kenosha WI 53142-7015 Ph: (262) 654-1004 | Professional Services Group, Inc. 2108 63rd St Kenosha WI 53143-4454 Ph: (262) 652-2406 |
| NPI Number | 1619024262 |
|---|---|
| Provider Enumeration Date | 01/05/2007 |
| Last Update Date | 06/13/2025 |
| Certification Date | 06/13/2025 |
| Medicare PECOS PAC ID | 8224296454 |
|---|---|
| Medicare Enrollment ID | O20120220000742 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619024262 | NPI | - | NPPES |
| 42125700 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | () | Secondary |
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | () | Primary |
| Provider Name | Shannon G O Brien |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366529182 PECOS PAC ID: 9032010657 Enrollment ID: I20040116000553 |
| Provider Name | Lisa S Thill |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841377694 PECOS PAC ID: 6800886664 Enrollment ID: I20040513001194 |
| Provider Name | Rosalyn Lakey Mcfarland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821245028 PECOS PAC ID: 0547320962 Enrollment ID: I20081114000636 |
| Provider Name | Timothy J Schwaller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851542864 PECOS PAC ID: 5698933737 Enrollment ID: I20120221000866 |
| Provider Name | Brian a Wolf |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1609982040 PECOS PAC ID: 8426216680 Enrollment ID: I20120521000466 |
| Provider Name | Kemba M Banyard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295080521 PECOS PAC ID: 4587682331 Enrollment ID: I20120917000814 |
| Provider Name | Leah J Featherstone |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1558619379 PECOS PAC ID: 9032349550 Enrollment ID: I20140303000716 |
| Provider Name | Jonathan T Grapengieser |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1467703223 PECOS PAC ID: 1355565946 Enrollment ID: I20140623001523 |
| Provider Name | Kenya Renee Robertson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356629851 PECOS PAC ID: 6608098991 Enrollment ID: I20141121001136 |
| Provider Name | Angelia Felton-wilks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669720041 PECOS PAC ID: 5395048268 Enrollment ID: I20160127000641 |
| Provider Name | Jennifer Brau |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134591092 PECOS PAC ID: 8729377379 Enrollment ID: I20160520000616 |
| Provider Name | Annmarie K Ransom |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679959829 PECOS PAC ID: 3375852924 Enrollment ID: I20161110000510 |
| Provider Name | Karen S Lim |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316073836 PECOS PAC ID: 4981834447 Enrollment ID: I20161220001597 |
| Provider Name | Daniel Dashner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144621376 PECOS PAC ID: 5698050573 Enrollment ID: I20170315001213 |
| Provider Name | Tierney Voit |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396284683 PECOS PAC ID: 3870860141 Enrollment ID: I20170517002238 |
| Provider Name | Jennifer L Evancy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154486876 PECOS PAC ID: 9335417419 Enrollment ID: I20170613002719 |
| Provider Name | Dionna Lashaun Mcferrin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841746443 PECOS PAC ID: 4789956996 Enrollment ID: I20170823002408 |
| Provider Name | Octavia N Manuel-wright |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598950396 PECOS PAC ID: 6406129352 Enrollment ID: I20170829001736 |
| Provider Name | Renee M Morin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609388693 PECOS PAC ID: 2567720972 Enrollment ID: I20171212002435 |
| Provider Name | Kimberly Berndt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083923049 PECOS PAC ID: 6901144880 Enrollment ID: I20190219002868 |
| Provider Name | Amy Macdonald Wojcik |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669943874 PECOS PAC ID: 1850624925 Enrollment ID: I20190604001918 |
| Provider Name | Elizabeth Mundy-hemmerich |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386834075 PECOS PAC ID: 2668795477 Enrollment ID: I20191220000177 |
| Provider Name | Deshawntae Griffin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649810938 PECOS PAC ID: 5395171995 Enrollment ID: I20200130000035 |
| Provider Name | Kathryn Koenig-leuck |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1679098743 PECOS PAC ID: 6507293818 Enrollment ID: I20200226002434 |
| Provider Name | Kayla Stoltmann |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124551627 PECOS PAC ID: 6103230636 Enrollment ID: I20210125002160 |
| Provider Name | Laura Jean Zellmer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457895658 PECOS PAC ID: 2163797986 Enrollment ID: I20210518002523 |
| Provider Name | Shanna Thomsen |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1417438250 PECOS PAC ID: 6204232531 Enrollment ID: I20210910002168 |
| Provider Name | Elizabeth G Gamboa-reynolds |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689255291 PECOS PAC ID: 3971999616 Enrollment ID: I20220406001914 |
| Provider Name | Ellen Hanzalik-meo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801327077 PECOS PAC ID: 4183003403 Enrollment ID: I20220616001857 |
| Provider Name | Jennifer Conrardy |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1942936539 PECOS PAC ID: 6608251962 Enrollment ID: I20220922002036 |
| Provider Name | Sarah Vogt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992220727 PECOS PAC ID: 6002280088 Enrollment ID: I20230314001382 |
| Provider Name | Jeremy L Kaup |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649970773 PECOS PAC ID: 8224493911 Enrollment ID: I20230502002758 |
| Provider Name | Rachel C Vande Hei |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376120279 PECOS PAC ID: 6709245350 Enrollment ID: I20230629003822 |
| Provider Name | Angela Dellise |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1164718151 PECOS PAC ID: 2163874819 Enrollment ID: I20240117004662 |
| Provider Name | Angela J Kuffel |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1053787788 PECOS PAC ID: 1951753359 Enrollment ID: I20240122003068 |
| Provider Name | Angela Langenfeld |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1326598921 PECOS PAC ID: 1759734957 Enrollment ID: I20240124001227 |
| Provider Name | Dana Robinson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1598434870 PECOS PAC ID: 9931552148 Enrollment ID: I20240124001576 |
| Provider Name | Heather Cooper |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1568058238 PECOS PAC ID: 8729421672 Enrollment ID: I20240207002179 |
| Provider Name | Jennifer Marie Dahlke |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1518447754 PECOS PAC ID: 4082057724 Enrollment ID: I20240208004357 |
| Provider Name | Dawn Miller-duval |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1417484155 PECOS PAC ID: 9133562853 Enrollment ID: I20240209002373 |
| Provider Name | Kerah Mae Modesti |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1477133510 PECOS PAC ID: 7719320167 Enrollment ID: I20240213001956 |
| Provider Name | Michelle M. Runnion |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1912117318 PECOS PAC ID: 1153589312 Enrollment ID: I20240214001888 |
| Provider Name | Jessica Martzahl |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1033685474 PECOS PAC ID: 3971947003 Enrollment ID: I20240216002724 |
| Provider Name | Susanne Smith |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1194322065 PECOS PAC ID: 6608210521 Enrollment ID: I20240220000834 |
| Provider Name | Magdalene Helene Danzer-malinowski |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1003586587 PECOS PAC ID: 2860836459 Enrollment ID: I20240222001999 |
| Provider Name | Sierra Worob |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568031284 PECOS PAC ID: 4082058680 Enrollment ID: I20240222002520 |
| Provider Name | Latrice Marshall |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1336703750 PECOS PAC ID: 3476997917 Enrollment ID: I20240222003822 |
| Provider Name | Marjorie Y Mendoza |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1124324090 PECOS PAC ID: 8123463437 Enrollment ID: I20240227000821 |
| Provider Name | Nicole Ann Lensmire |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1528660990 PECOS PAC ID: 4880031533 Enrollment ID: I20240318002503 |
| Provider Name | Daysi Jimenez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427773266 PECOS PAC ID: 7719329747 Enrollment ID: I20240522003087 |
| Provider Name | Catherine Jean Podolske |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699444141 PECOS PAC ID: 7214460674 Enrollment ID: I20241024001364 |
| Provider Name | Brea Ann Quadracci |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1396441168 PECOS PAC ID: 1850825274 Enrollment ID: I20241107002746 |
| Provider Name | Macarena Correa Villa |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1467152728 PECOS PAC ID: 4789112434 Enrollment ID: I20250109001409 |
| Provider Name | Anjuli Dominique Holmes |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1609648641 PECOS PAC ID: 2163947284 Enrollment ID: I20250421002592 |
| Provider Name | Mia Chapple |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487363552 PECOS PAC ID: 2961875885 Enrollment ID: I20250514003095 |
| Provider Name | Moriah Gomez White |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1154016046 PECOS PAC ID: 9638682453 Enrollment ID: I20250703000326 |
| Provider Name | Casey Nicole Gittens |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124752050 PECOS PAC ID: 7214438415 Enrollment ID: I20250828005270 |
| Provider Name | Jennifer Ann Spors |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1356197727 PECOS PAC ID: 0143717389 Enrollment ID: I20251013002709 |
| Provider Name | Shelbria Leigh-anne Wachtveitl |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568201671 PECOS PAC ID: 9537658729 Enrollment ID: I20251028003974 |
| Provider Name | Elizabeth Cosich-georgetta |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1326823816 PECOS PAC ID: 2264923622 Enrollment ID: I20251113000555 |
| Provider Name | Amber Brozek |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417729898 PECOS PAC ID: 1850882077 Enrollment ID: I20251117000817 |
| Provider Name | Maria Cowan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1356061261 PECOS PAC ID: 6305338179 Enrollment ID: I20251120000469 |
| Provider Name | Kyle Butler |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1548965148 PECOS PAC ID: 2668965963 Enrollment ID: I20251204003307 |
| Provider Name | Daniel Phonzie Kaprelian |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1285334367 PECOS PAC ID: 9234624180 Enrollment ID: I20251218002447 |
| Provider Name | Helene Zaffiro |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083377907 PECOS PAC ID: 6002302668 Enrollment ID: I20260102001701 |
| Provider Name | Tamara Ambre |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588850168 PECOS PAC ID: 1850877440 Enrollment ID: I20260114000544 |
| Provider Name | Jessica Schmidt |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1629763735 PECOS PAC ID: 5496233595 Enrollment ID: I20260130000370 |
| Provider Name | Erica Schad |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1174304125 PECOS PAC ID: 1658851522 Enrollment ID: I20260218003027 |
| Provider Name | Anna Mcelwain |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093472672 PECOS PAC ID: 2668955402 Enrollment ID: I20260310004480 |
| Provider Name | Rachel Skarsten |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1871441204 PECOS PAC ID: 7214412865 Enrollment ID: I20260331004660 |
| Provider Name | Ashley J Devitt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952004756 PECOS PAC ID: 3779068275 Enrollment ID: I20260402001066 |
| Provider Name | Kerry Eskra |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1710260021 PECOS PAC ID: 8527534635 Enrollment ID: I20260416001794 |
Calming Waves Therapy, LLC Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 2901 35th St, Kenosha, WI 53140 Phone: 815-904-0185 |
Neuropsychological Consultants Inc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 5017 Green Bay Rd Ste 130, Kenosha, WI 53144 Phone: 262-671-1334 |
Clearview Counseling Group Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 10900 67th St, Kenosha, WI 53142 Phone: 262-914-7422 |
Pathways Counseling Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1025 56th St, Kenosha, WI 53140 Phone: 262-237-1186 |
Kenosha County Department of Human Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 8600 Sheridan Road, Suite 100, Kenosha, WI 53143 Phone: 262-605-6524 Fax: 262-697-4655 |
Journey House International Center LLC Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 8032 22nd Ave # 5151, Kenosha, WI 53143 Phone: 262-289-4378 Fax: 262-288-4353 |