Rogers Behavioral Health - Wisconsin Sc | |
34700 Valley Rd Oconomowoc WI 53066-4500 | |
(800) 767-4411 | |
Not Available |
Full Name | Rogers Behavioral Health - Wisconsin Sc |
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Speciality | Psychiatry & Neurology |
Location | 34700 Valley Rd, Oconomowoc, Wisconsin |
Authorized Official Name and Position | Cindy Meyer (PRESIDENT AND CEO) |
Authorized Official Contact | 2623030580 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Rogers Behavioral Health - Wisconsin Sc 34700 Valley Rd Oconomowoc WI 53066-4500 Ph: (262) 646-4411 | Rogers Behavioral Health - Wisconsin Sc 34700 Valley Rd Oconomowoc WI 53066-4500 Ph: (800) 767-4411 |
NPI Number | 1699524751 |
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Provider Enumeration Date | 05/13/2024 |
Last Update Date | 01/23/2025 |
Certification Date | 01/23/2025 |
Medicare PECOS PAC ID | 4486175122 |
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Medicare Enrollment ID | O20250310003530 |
Identifier | Type | State | Issuer |
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1699524751 | NPI | - | NPPES |
Provider Name | Jerry L Halverson |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1952360422 PECOS PAC ID: 0840265484 Enrollment ID: I20040827000820 |
Provider Name | Abdul Mateen Khazi |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1023208592 PECOS PAC ID: 8426109752 Enrollment ID: I20090626000507 |
Provider Name | Nathan A Valentine |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1932372778 PECOS PAC ID: 2264682061 Enrollment ID: I20150925000051 |
Provider Name | Christopher R Takala |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1013203652 PECOS PAC ID: 9032366638 Enrollment ID: I20160817001929 |
Provider Name | Sean Robert Lenoue |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1750670683 PECOS PAC ID: 4486894896 Enrollment ID: I20181112001444 |
Provider Name | Courtney Lauren Pflughoeft |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1992399067 PECOS PAC ID: 2769899079 Enrollment ID: I20210405001137 |
Provider Name | Gregory M Evangelatos |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1659725448 PECOS PAC ID: 3870927437 Enrollment ID: I20210623002582 |
Provider Name | Angela M Shengena |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1215606124 PECOS PAC ID: 6204205883 Enrollment ID: I20221205001413 |
Provider Name | Daniel Peter Mccool |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1891415154 PECOS PAC ID: 6002272333 Enrollment ID: I20230511002398 |
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