Tombolo, LLC

Primary specialty

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

License

7050-123 Issued in WI

Legal business name

TOMBOLO, LLC

Practice address

12545 W. Burleigh Rd.
Suite 10
Brookfield, WI 53005

Phone

(414) 708-5988

NPI assigned

Aug 1, 2017

Organization subpart

No

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

Authorized official

Name

Ms. Renee L. Genin, LCSW

Title

Psychotherapist/Child Specialist

Phone

(414) 708-5988

Specialties & licenses 3

Addresses

Other names 1

• Connections Doing business as

Locations

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

{
    "created_epoch": "1501545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1407370398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12545 W BURLEIGH RD STE 10",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530053101",
            "telephone_number": "414-708-5988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12545 W. BURLEIGH RD.",
            "address_2": "SUITE 10",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "53005",
            "telephone_number": "414-708-5988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOMBOLO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-01",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "GENIN",
        "authorized_official_first_name": "RENEE",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PSYCHOTHERAPIST/CHILD SPECIALIST",
        "authorized_official_telephone_number": "414-708-5988",
        "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": "7050-123",
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "WI",
            "license": "7050-123",
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "WI",
            "license": "7050-123",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Connections",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Elizabeth Tollenaar
• Christina Marie Tolson, NP
• Kamaldeep S Toor, OD
• Claire M Topp, MS, ED S, NCSP, BCBA
• Catherine Elizabeth Torres, PTA
• Grace Kim Tosi, DDS
• Total Renal Care Inc

• Mental Health Clinic/Center (Including Community Mental Health Center) in Brookfield, WI
• Providers in Brookfield, WI by specialty
• 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 Jul 21, 2022; 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.