Applied Therapies & Wellness Center, S.C.
Organization Active NPI Mental Health Clinic/Center (Including Community Mental Health Center) · Brookfield, WI
NPI 1356569115 · NPPES record last updated Mar 20, 2024
Key facts
- NPI
- 1356569115
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
- Legal business name
- APPLIED THERAPIES & WELLNESS CENTER, S.C.
- Practice address
- 150 N. Sunnyslope Rd. Ste 372
Brookfield, WI 53005-4806 - Phone
- (414) 302-1233
- Fax
- (262) 788-9662
- NPI assigned
- Apr 24, 2007
- Organization subpart
- No
Authorized official
- Name
- Ms. Trisha Wollin, LCSW, RPT-S
- Title
- Owner/Registered Agent
- Phone
- (414) 302-1233
Practitioners 12
-
Trisha Wollin, L.C.S.W.; S.A.C.
-
Sarah Alice Clubb, APSW
-
Ashley Nicole Koehler, LCSW
-
Heather Chernetski, LPC-IT
-
Jennifer Ann Eggert, MS, LPC-IT, NCC
-
Stephanie A Mager, MS, LPC, SAC-IT
-
Darlene Shea, LPC
-
Karissa Vega, LPC
-
Catrina Lewis, LPC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110331000401 | WI | Part B Supplier - Clinic/Group Practice | 4880877604 |
Receives reassigned benefits from 1 practitioner Practice locations: Brookfield, WI |
National Provider Directory
Locations
150 N Sunny Slope Rd
Ste 372
Brookfield, WI 53005
Phone (262) 302-1233
12970 W Bluemound Rd
Ste 304
Elm Grove, WI 53122
Phone (414) 302-1233
1033 N Mayfair Rd
Ste 305
Wauwatosa, WI 53226
Phone (414) 302-1233
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker |
1041C0700X | 6747-123 | ||
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | Yes |
Addresses
Primary practice location
150 N. Sunnyslope Rd. Ste 372
Brookfield, WI 53005-4806
Mailing address
150 N. Sunnyslope Rd. Ste 372
Brookfield, WI 53005-4806
Phone (414) 302-1233
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356569115 | Medicaid | WI |
Other providers in Brookfield, WI
- Tiffany Sue Anewenter-Grinker
- Anne Huebner & Associates LLC
- Angela Anthony
- Tamara Anthony
- Linda Marie Anton
- Siamak Arassi
- Ricardo E Araujo
- Aria at Care Age LLC
- Aria of Brookfield LLC
- Arndt Chiropractic LLC
All providers in Brookfield, 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 Mar 20, 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.