| West Grove Clinic, Llc | |
|
10012 W. Capitol Dr. #101 Wauwatosa WI 53222-1300 | |
| (414) 810-4844 | |
| (414) 810-4845 |
| Full Name | West Grove Clinic, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 10012 W. Capitol Dr. #101, Wauwatosa, Wisconsin |
| Authorized Official Name and Position | Selahattin S. Kurter (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 4148104844 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| West Grove Clinic, Llc 10012 W. Capitol Dr #101 Wauwatosa WI 53222-1300 Ph: (414) 810-4844 | West Grove Clinic, Llc 10012 W. Capitol Dr. #101 Wauwatosa WI 53222-1300 Ph: (414) 810-4844 |
| NPI Number | 1518167477 |
|---|---|
| Provider Enumeration Date | 07/19/2007 |
| Last Update Date | 12/29/2014 |
| Medicare PECOS PAC ID | 2264476688 |
|---|---|
| Medicare Enrollment ID | O20050616000721 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518167477 | NPI | - | NPPES |
| 42229100 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 2318 (Wisconsin) | Primary |
| Provider Name | David W Schulz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1821031337 PECOS PAC ID: 7113930629 Enrollment ID: I20060731000396 |
| Provider Name | Carolyn B Morris |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811188964 PECOS PAC ID: 0345335311 Enrollment ID: I20071005000221 |
| Provider Name | Ariella M Danowski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265887038 PECOS PAC ID: 6507155579 Enrollment ID: I20160513001238 |
| Provider Name | Selahattin Said Kurter |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164596615 PECOS PAC ID: 6709891047 Enrollment ID: I20210122000097 |
| Provider Name | Abigail Czarnecki |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124783006 PECOS PAC ID: 0749623049 Enrollment ID: I20240202002966 |
| Provider Name | Kurt Peterson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1902241888 PECOS PAC ID: 6406299973 Enrollment ID: I20240212003172 |
| Provider Name | Elizabeth Ann Mueller |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1780169433 PECOS PAC ID: 9638514797 Enrollment ID: I20240228001814 |
| Provider Name | Savannah Marie Muench |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1477152221 PECOS PAC ID: 9931544012 Enrollment ID: I20240228002803 |
| Provider Name | Holly Marie Majerus |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1245704386 PECOS PAC ID: 2567807654 Enrollment ID: I20240228002884 |
| Provider Name | Jean Moral |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1326582149 PECOS PAC ID: 7618312752 Enrollment ID: I20240228004594 |
| Provider Name | Meredith Robbins |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1407480619 PECOS PAC ID: 3779928544 Enrollment ID: I20240302000526 |
| Provider Name | Julianne Witthuhn |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1760649479 PECOS PAC ID: 0042655847 Enrollment ID: I20240304000492 |
| Provider Name | Jaimie Hauch |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1881936490 PECOS PAC ID: 0547605214 Enrollment ID: I20240304003373 |
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