| Trilogy Behavioral Health Services | |
|
7384 N 60th St Brown Deer WI 53223-4602 | |
| (414) 737-4774 | |
| Not Available |
| Full Name | Trilogy Behavioral Health Services |
|---|---|
| Speciality | Clinic/Center |
| Location | 7384 N 60th St, Brown Deer, Wisconsin |
| Authorized Official Name and Position | Shalonda N Myles (OWNER) |
| Authorized Official Contact | 4147028339 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Trilogy Behavioral Health Services 6400 Industrial Loop Greendale WI 53129-2452 Ph: (414) 702-8339 | Trilogy Behavioral Health Services 7384 N 60th St Brown Deer WI 53223-4602 Ph: (414) 737-4774 |
| NPI Number | 1508586033 |
|---|---|
| Provider Enumeration Date | 09/02/2022 |
| Last Update Date | 08/21/2023 |
| Certification Date | 07/17/2023 |
| Medicare PECOS PAC ID | 5193191716 |
|---|---|
| Medicare Enrollment ID | O20221021001250 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508586033 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Veronica Ashlene Powell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811552623 PECOS PAC ID: 3072841212 Enrollment ID: I20190826001578 |
| Provider Name | Shalonda Myles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659569929 PECOS PAC ID: 5092143750 Enrollment ID: I20200312001297 |
| Provider Name | Amanda Marie Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558886598 PECOS PAC ID: 7517387913 Enrollment ID: I20201024000030 |
| Provider Name | Mikar Yang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205592425 PECOS PAC ID: 7113305467 Enrollment ID: I20220527001812 |
| Provider Name | Yasmin Majumder |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811305766 PECOS PAC ID: 1254559446 Enrollment ID: I20220705003088 |
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