| Shorehaven Behavioral Health Inc | |
|
8405 W Forest Home Av Suite 104 Milwaukee WI 53228 | |
| (414) 540-2170 | |
| (414) 540-2171 |
| Full Name | Shorehaven Behavioral Health Inc |
|---|---|
| Speciality | Art Therapist |
| Location | 8405 W Forest Home Av, Milwaukee, Wisconsin |
| Authorized Official Name and Position | Don David Rosenberg (PRESIDENT) |
| Authorized Official Contact | 4145402170 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shorehaven Behavioral Health Inc 3900 W Brown Deer Rd Suite 200 Brown Deer WI 53209 Ph: (414) 540-2170 | Shorehaven Behavioral Health Inc 8405 W Forest Home Av Suite 104 Milwaukee WI 53228 Ph: (414) 540-2170 |
| NPI Number | 1598800740 |
|---|---|
| Provider Enumeration Date | 02/21/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 0143324954 |
|---|---|
| Medicare Enrollment ID | O20070404000380 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598800740 | NPI | - | NPPES |
| Provider Name | Bruce A Semon |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1114020773 PECOS PAC ID: 3971498866 Enrollment ID: I20040219000202 |
| Provider Name | Valynda Wells |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1164480489 PECOS PAC ID: 1557301876 Enrollment ID: I20050505001075 |
| Provider Name | Clare Ann Lewis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972604809 PECOS PAC ID: 7517975311 Enrollment ID: I20060404000700 |
| Provider Name | David Jonathan Goodman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1649380924 PECOS PAC ID: 6103825906 Enrollment ID: I20061205000244 |
| Provider Name | Jessica A Weyer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104924018 PECOS PAC ID: 6204905524 Enrollment ID: I20080513000324 |
| Provider Name | Jennifer Bleak |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1013124239 PECOS PAC ID: 0648410662 Enrollment ID: I20130715000611 |
| Provider Name | Eliese C Rucktenwald |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689851313 PECOS PAC ID: 9739323304 Enrollment ID: I20130920000536 |
| Provider Name | James A Jensen |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1083777635 PECOS PAC ID: 9032336334 Enrollment ID: I20140811000809 |
| Provider Name | Christina M Brigham |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467796433 PECOS PAC ID: 7113244872 Enrollment ID: I20150318001303 |
| Provider Name | Gary R Swan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043633159 PECOS PAC ID: 0648590521 Enrollment ID: I20150515001309 |
| Provider Name | Katie Hodgson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447620448 PECOS PAC ID: 3173806221 Enrollment ID: I20170215001224 |
| Provider Name | Todd Thomas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932452448 PECOS PAC ID: 8921385816 Enrollment ID: I20170502000945 |
| Provider Name | Kayla E Murphy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770943961 PECOS PAC ID: 9537429071 Enrollment ID: I20180201001879 |
| Provider Name | Kathleen Anderson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992175574 PECOS PAC ID: 2163783341 Enrollment ID: I20180305000428 |
| Provider Name | Mark La Fave |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1588121172 PECOS PAC ID: 6507297173 Enrollment ID: I20200514002101 |
| Provider Name | Samantha Chittenden |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407204100 PECOS PAC ID: 4880001494 Enrollment ID: I20210326002303 |
| Provider Name | Elisabeth Williams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962909143 PECOS PAC ID: 9739582925 Enrollment ID: I20210726002478 |
| Provider Name | Jenna Mohelnitzky |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013488022 PECOS PAC ID: 3274907183 Enrollment ID: I20230316000094 |
| Provider Name | Ayesha Maria |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1356813042 PECOS PAC ID: 3173973443 Enrollment ID: I20231228002346 |
| Provider Name | Linda Pulice |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1629644208 PECOS PAC ID: 3072963347 Enrollment ID: I20231228002385 |
| Provider Name | Farrukh Ghazala |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1104179019 PECOS PAC ID: 4183074495 Enrollment ID: I20231229000001 |
| Provider Name | Payton Lett |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1336663145 PECOS PAC ID: 3870943079 Enrollment ID: I20240101000175 |
| Provider Name | Leslie Marie Berumen |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1578855672 PECOS PAC ID: 5597115790 Enrollment ID: I20240101000228 |
| Provider Name | Anthony Roach |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1083968200 PECOS PAC ID: 9537510391 Enrollment ID: I20240105003918 |
| Provider Name | Linda Renee Jowett |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1578856738 PECOS PAC ID: 4284085911 Enrollment ID: I20240108003137 |
| Provider Name | Caylee Kennedy |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1992395271 PECOS PAC ID: 5294186466 Enrollment ID: I20240111004458 |
| Provider Name | Sarah Denkert |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1093329344 PECOS PAC ID: 6608228663 Enrollment ID: I20240116002085 |
| Provider Name | Sarah Sleider |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740927110 PECOS PAC ID: 4486006889 Enrollment ID: I20240122003177 |
| Provider Name | Tonya Jean Hale |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1477613479 PECOS PAC ID: 9537512520 Enrollment ID: I20240125003237 |
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