| Rechek Psychotherapy Services Llc | |
|
101 Wisconsin American Dr Ste 150 Fond Du Lac WI 54937-6704 | |
| (920) 583-0760 | |
| Not Available |
| Full Name | Rechek Psychotherapy Services Llc |
|---|---|
| Speciality | Counselor |
| Location | 101 Wisconsin American Dr Ste 150, Fond Du Lac, Wisconsin |
| Authorized Official Name and Position | Laurie A Rechek (OWNER) |
| Authorized Official Contact | 9205830760 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rechek Psychotherapy Services Llc 924 Rock Ave Waupun WI 53963-1218 Ph: (920) 583-0760 | Rechek Psychotherapy Services Llc 101 Wisconsin American Dr Ste 150 Fond Du Lac WI 54937-6704 Ph: (920) 583-0760 |
| NPI Number | 1841030814 |
|---|---|
| Provider Enumeration Date | 05/28/2024 |
| Last Update Date | 06/19/2024 |
| Certification Date | 06/19/2024 |
| Medicare PECOS PAC ID | 6305381914 |
|---|---|
| Medicare Enrollment ID | O20240708002923 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841030814 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Laurie Ann Rechek |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144757394 PECOS PAC ID: 1658701719 Enrollment ID: I20200414001543 |
| Provider Name | Hannah K Domasky |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1447824982 PECOS PAC ID: 4183075203 Enrollment ID: I20240112001388 |
| Provider Name | Tammi Cassidy |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1275088577 PECOS PAC ID: 2365988623 Enrollment ID: I20240723000829 |
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