Kettle Moraine Behavioral Health

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

KETTLE MORAINE BEHAVIORAL HEALTH

Practice address

N158 Tamarack Rd
Palmyra, WI 53156-9789

Phone

(262) 745-0368

NPI assigned

Apr 4, 2016

Last updated

Apr 4, 2016By 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

Ms. Marcia Catlett, LCPC, LPC, MA, MEDNPI 1053457044

Title

Owner

Phone

(262) 745-0368

Specialties & licenses 1

Addresses

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.

• Marcia Anne Catlett, LCPC, LPC, MA, MED

  • Professional Counselor
  • Palmyra, WI
  • NPI 1053457044
  NPD (past) Authorized official

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

{
    "created_epoch": "1459728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459728000000",
    "number": "1174986376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 732",
            "city": "LAKE GENEVA",
            "state": "WI",
            "postal_code": "531470732",
            "telephone_number": "262-745-0368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N158 TAMARACK RD",
            "city": "PALMYRA",
            "state": "WI",
            "postal_code": "531569789",
            "telephone_number": "262-745-0368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KETTLE MORAINE BEHAVIORAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-04",
        "last_updated": "2016-04-04",
        "status": "A",
        "authorized_official_last_name": "CATLETT",
        "authorized_official_first_name": "MARCIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "262-745-0368",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCPC, LPC, MA, MED"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Palmyra, WI
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• Community/Behavioral Health Agency in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2016; 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.