Madison Psychotherapy Center, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

MADISON PSYCHOTHERAPY CENTER, LLC

Practice address

702 N Blackhawk Ave
Suite 205
Madison, WI 53705-3357

Phone

(608) 233-3037

Fax

(608) 233-5893

NPI assigned

Mar 3, 2015

Last updated

Mar 3, 2015By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mary Ellen Miller, MS LPC

Title

Clinic Director

Phone

(608) 233-3037

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Linda Carter Pettersen, MSW

  • Clinical Social Worker
  • Monona, WI
  • NPI 1518014372
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1425340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425340800000",
    "number": "1063804870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 N BLACKHAWK AVE",
            "address_2": "SUITE 205",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "539013357",
            "telephone_number": "608-233-3037",
            "fax_number": "608-233-5893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 N BLACKHAWK AVE",
            "address_2": "SUITE 205",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537053357",
            "telephone_number": "608-233-3037",
            "fax_number": "608-233-5893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADISON PSYCHOTHERAPY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-03",
        "last_updated": "2015-03-03",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "MARY ELLEN",
        "authorized_official_title_or_position": "CLINIC DIRECTOR",
        "authorized_official_telephone_number": "608-233-3037",
        "authorized_official_credential": "MS LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1902023435",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Madison Psychiatric & Psychological Services
• Madison Psychological and Spiritual Wellness, LLC
• Madison Psychotherapy and Wellness LLC
• Madison Psychotherapy Associates, Inc.
• Madison Psychotherapy Associates,Inc.
• Madison Psychotherapy Center, LLC
• Madison Radiologists S C
• Madison Rehabilitation Hospital, LLC (UW Health Rehabilitation Hospital)
• Madison Reliable Care Service
• Madison Senior Living, Inc. (Madison Pointe Senior Living)

• Mental Health Counselor in Madison, WI
• Providers in Madison, WI by specialty
• Mental Health Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.