Ironwood Mental Health LLC

Primary specialty

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

Legal business name

IRONWOOD MENTAL HEALTH LLC

Practice address

403 N Grand Ave # 101
Waukesha, WI 53186-4984

Phone

(262) 300-4948

NPI assigned

Aug 21, 2023

Organization subpart

No

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

Authorized official

Name

Regina Van GordenNPI 1194950204

Title

Owner

Phone

(262) 300-4948

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Regina Van Gorden, R.N., APNP, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Waukesha, WI
  • NPI 1194950204
  NPD Authorized official

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

{
    "created_epoch": "1692576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709769600000",
    "number": "1508640814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 N GRAND AVE # 101",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531864984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 N GRAND AVE # 101",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531864984",
            "telephone_number": "262-300-4948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IRONWOOD MENTAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-21",
        "last_updated": "2024-03-07",
        "certification_date": "2024-03-07",
        "status": "A",
        "authorized_official_last_name": "VAN GORDEN",
        "authorized_official_first_name": "REGINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "262-300-4948"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anthony Inzeo
• Kathryn D. Iorio, MD
• Muhammad Usama Iqbal
• Tracey A Irene, AU.D.
• Iris Health Clinic
• Fiona Isaku
• Samantha Rae Ishman, PHARMD
• Dianne Isnard
• Mike Ivans
• Hayley Beth Ivers, MS, LPC-IT

• Mental Health Clinic/Center (Including Community Mental Health Center) in Waukesha, WI
• Providers in Waukesha, 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 Mar 7, 2024; 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.