Northland Community Services Inc
Organization Active NPI Mental Health Clinic/Center (Including Community Mental Health Center) · Westfield, WI
NPI 1215075296 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1215075296
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
- Legal business name
- NORTHLAND COMMUNITY SERVICES INC
- Practice address
- 161 Spring St
Westfield, WI 53964 - Phone
- (608) 296-2139
- Fax
- (608) 296-1590
- NPI assigned
- Feb 2, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Jon S Matthew, PHD
- Title
- Director
- Phone
- (608) 296-2139
Corporate family (same tax ID) 5
Practitioners 6
-
Jon S Matthew, PH.D.
-
Sherry Lea Baumgart, D.C.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20041202000301 | WI | Part B Supplier - Clinic/Group Practice | 4981514387 |
Receives reassigned benefits from 4 practitioners Practice locations: Adams, WI; Westfield, WI |
National Provider Directory
- Tax ID family
- Northland Community Services Inc
Locations
139 S Main St
Adams, WI 53910
Phone (608) 296-2139
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | Yes |
Addresses
Primary practice location
161 Spring St
Westfield, WI 53964
Mailing address
PO Box 248
Westfield, WI 53964-0248
Phone (608) 296-2139
Other providers in Westfield, WI
- Barbara L.S. Marr
- Jon S Matthew
- Moundview Memorial Hospital & Clinics, Inc.
- Northland Community Services Crisis
- Northland Community Services CSP
- Northland Community Services Inc
- Northland Community Services Inc.
- Northland Home Health
- Pace Chiropractic Office SC
- Terry Ann Pace
All providers in Westfield, WI · Mental Health Clinic/Center (Including Community Mental Health Center) in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.