Madison Psychotherapy Associates, Inc.

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

License

1552 Issued in WI

Legal business name

MADISON PSYCHOTHERAPY ASSOCIATES, INC.

Practice address

1912 Atwood Ave
Suite #5
Madison, WI 53704-5461

Phone

(608) 251-0839

Fax

(608) 255-2752

NPI assigned

May 3, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Rose Ghilardi, LCSW

Title

Office Manager

Phone

(608) 251-0839

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Donald Wayne Cooper, LCSW

  • Clinical Social Worker
  • Madison, WI
  • NPI 1962591859
  NPD (past)
• Richard Louis Russo, LCSW

  • Clinical Social Worker
  • Madison, WI
  • NPI 1053405100
  NPD (past)

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196640000000",
    "number": "1295957512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1912 ATWOOD AVE",
            "address_2": "SUITE #5",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537045461",
            "telephone_number": "608-251-0839",
            "fax_number": "608-255-2752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1912 ATWOOD AVE",
            "address_2": "SUITE #5",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537045461",
            "telephone_number": "608-251-0839",
            "fax_number": "608-255-2752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADISON PSYCHOTHERAPY ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2007-12-03",
        "status": "A",
        "authorized_official_last_name": "GHILARDI",
        "authorized_official_first_name": "ROSE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "608-251-0839",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "WI",
            "license": "1552",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42112900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Madison Psychotherapy and Wellness LLC
• Madison Psychotherapy Associates,Inc.
• Madison Psychotherapy Center, LLC
• Madison Psychotherapy Center, LLC
• Madison Radiologists S C
• Madison Rehabilitation Hospital, LLC

• All providers in Madison, WI
• Mental Health Clinic/Center (Including Community Mental Health Center) in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2007; 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.