Frances M. Augustine, CSAC,ICS,IDP/AT

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Madison, WI

NPI 1417112780 · NPPES record last updated Dec 17, 2012

Key facts

NPI
1417112780
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
15510130 (WI)
Practice address
810 W Olin Ave
Madison, WI 53715-2142
Phone
(608) 255-5922
Fax
(608) 255-0340
NPI assigned
Jul 25, 2008
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
15510130WIMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Hope Haven Rebos United Inc Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 15510130 WI Yes

Addresses

Primary practice location

810 W Olin Ave
Madison, WI 53715-2142

Mailing address

810 W Olin Ave
Madison, WI 53715-2142
Phone (608) 255-5922

Other identifiers

IdentifierTypeStateIssuer
1417112780MedicaidWI

Other providers in Madison, WI

All providers in Madison, WI · Addiction (Substance Use Disorder) Counselor in Wisconsin

Sources for this page

Verify at the official NPI Registry.