County of Door-Door County Library
Organization Active NPI Mental Health Clinic/Center (Including Community Mental Health Center) · Sturgeon Bay, WI
NPI 1245265693 · NPPES record last updated Feb 26, 2024
Key facts
- NPI
- 1245265693
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
- License
- 1283 (WI)
- Legal business name
- COUNTY OF DOOR-DOOR COUNTY LIBRARY
- Practice address
- 421 Nebraska St
Sturgeon Bay, WI 54235-2225 - Phone
- (920) 746-2345
- Fax
- (920) 746-2439
- NPI assigned
- Jul 12, 2006
- Organization subpart
- No
Authorized official
- Name
- Joseph A. Krebsbach
- Title
- Agency Director
- Phone
- (920) 746-2343
Other NPIs with the same Medicare PAC ID 2
Corporate family (same tax ID) 5
Practitioners 15
-
Rene Beth Domask, LPC
-
Danielle Nyman, MSW, APSW
-
Cassaundra N Bratz, LPC
-
Kristin Deprey, CSAC
-
Mary Belle Simac, B.S.
-
Michael P Sayers, PH D
-
Tracy E Conard, OTR
-
Carrie Marie Doell, LPC-IT
-
Jamie L Lowis, APSW
-
Julie A Toyne, M.A., CCC-SLP
-
Rebecca M Ullman, PHYSICAL THERAPIST
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20060103000615 | WI | Part B Supplier - Clinic/Group Practice | 2062434194 |
Receives reassigned benefits from 10 practitioners Practice locations: Sturgeon Bay, WI |
National Provider Directory
- Tax ID family
- Door County Public Heal
Locations
421 Nebraska St
Fl 2
Sturgeon Bay, WI 54235
421 Nebraska St
Sturgeon Bay, WI 54235
Phone (920) 746-2345
421 Nebraska St
Fl 1
Sturgeon Bay, WI 54235
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor |
101YA0400X | 1283 | WI | |
| Mental Health Counselor |
101YM0800X | 1283 | WI | |
| Cognitive & Behavioral Psychologist |
103TB0200X | |||
| Counseling Psychologist |
103TC1900X | 1283 | WI | |
| Intellectual & Developmental Disabilities Psychologist |
103TM1800X | |||
| Clinical Social Worker |
1041C0700X | 1283 | WI | |
| Marriage & Family Therapist |
106H00000X | |||
| Speech-Language Pathologist |
235Z00000X | |||
| Case Management Agency | 251B00000X | |||
| Public Health or Welfare Agency | 251K00000X | |||
| Community/Behavioral Health Agency | 251S00000X | 2159 | WI | |
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | 1283 | WI | Yes |
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | |||
| Multi-Specialty Clinic/Center | 261QM1300X | 1283 | WI |
Addresses
Primary practice location
421 Nebraska St
Sturgeon Bay, WI 54235-2225
Mailing address
421 Nebraska St
Sturgeon Bay, WI 54235-2225
Phone (920) 746-7155
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 42140200 | Medicaid | WI | |
| 43112400 | Medicaid | WI | |
| 43090300 | Medicaid | WI | |
| 41210100 | Medicaid | WI | |
| 43424300 | Medicaid | WI |
Other names
- Door County Department of Health and Human Services
Other providers in Sturgeon Bay, WI
- Tracy E Conard
- David G Conger
- Bernadette Conroy
- Counseling Associates of Door County, LLC
- County of Door-Door County Library
- County of Door-Door County Library
- Amanda Marie Court
- Brooke Cravillion
- Colleen Dachelet
- Scott A Dadam
All providers in Sturgeon Bay, 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 Feb 26, 2024. 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.