NPIMap

Organization Active NPI

Edelweiss Behavioral Health LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Madison, WI
National Provider Identifier
1194128785
Registry record updated Sep 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
E045838 Issued in WI
Legal business name
EDELWEISS BEHAVIORAL HEALTH LLC
Practice address
6402 Odana Rd
Madison, WI 53719-1123
Phone
(608) 695-0674
NPI assigned
Sep 27, 2014
Last updated
Sep 27, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2014

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

Authorized official

Name
Anna Aufderhaar, LPC
Title
Owner/LPC
Phone
(608) 695-0674

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X E045838 WI Primary

Addresses

Primary practice location

6402 Odana Rd
Madison, WI 53719-1123

Mailing address

6402 Odana Rd
Madison, WI 53719-1123
Phone (608) 695-0674

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250317002453 WI Part B Supplier - Clinic/Group Practice 6709308059 Receives reassigned benefits from 3 practitioners
Practice locations: Madison, WI

National Provider Directory

National Provider Directory

Locations

725 Heartland Trl
Ste 301
Madison, WI 53717
Phone (608) 205-4450

Practitioners & affiliated clinicians

Practitioners 19

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.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1411776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411776000000",
    "number": "1194128785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6402 ODANA RD",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537191123",
            "telephone_number": "608-695-0674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6402 ODANA RD",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537191123",
            "telephone_number": "608-695-0674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDELWEISS BEHAVIORAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-27",
        "last_updated": "2014-09-27",
        "status": "A",
        "authorized_official_last_name": "AUFDERHAAR",
        "authorized_official_first_name": "ANNA",
        "authorized_official_title_or_position": "OWNER/LPC",
        "authorized_official_telephone_number": "608-695-0674",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "WI",
            "license": "E045838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.