| Psychiatric Services Of Racine, Llp | |
|
8700 Durand Ave Ste 600 Sturtevant WI 53177-2096 | |
| (262) 635-5520 | |
| (262) 635-5530 |
| Full Name | Psychiatric Services Of Racine, Llp |
|---|---|
| Speciality | Psychologist |
| Location | 8700 Durand Ave Ste 600, Sturtevant, Wisconsin |
| Authorized Official Name and Position | William J Bjerregaard (PARTNER) |
| Authorized Official Contact | 2626355520 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Psychiatric Services Of Racine, Llp 8700 Durand Ave Ste 600 Sturtevant WI 53177-2096 Ph: (262) 635-5520 | Psychiatric Services Of Racine, Llp 8700 Durand Ave Ste 600 Sturtevant WI 53177-2096 Ph: (262) 635-5520 |
| NPI Number | 1699791988 |
|---|---|
| Provider Enumeration Date | 07/14/2006 |
| Last Update Date | 03/27/2018 |
| Medicare PECOS PAC ID | 1658377148 |
|---|---|
| Medicare Enrollment ID | O20061005000400 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699791988 | NPI | - | NPPES |
| 42166000 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TP0016X | Psychologist - Prescribing (medical) | 1757 (Wisconsin) | Primary |
| Provider Name | David L Nichols |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1063409852 PECOS PAC ID: 3173529617 Enrollment ID: I20061006000077 |
| Provider Name | Ahmad Z Khan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629065404 PECOS PAC ID: 2769546118 Enrollment ID: I20090129000250 |
| Provider Name | Robert S Callaghan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275520033 PECOS PAC ID: 5991998155 Enrollment ID: I20101020000279 |
| Provider Name | William J Bjerregaard |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1043207806 PECOS PAC ID: 3375549892 Enrollment ID: I20101020000412 |
| Provider Name | Marilyn S Befera-zielinski |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1386631158 PECOS PAC ID: 8628236346 Enrollment ID: I20120225000115 |
Gray Matter Solutions Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3224 Kennsington Square Rd, Sturtevant, WI 53177 Phone: 262-206-0412 |