NPIMap

Organization Active NPI

Janesville Psychiatric Clinic Daytreatment for Children

  • Mental Health Counselor
  • Janesville, WI
National Provider Identifier
1578737706
Registry record updated Apr 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
1448 Issued in WI
Legal business name
JANESVILLE PSYCHIATRIC CLINIC DAYTREATMENT FOR CHILDREN
Practice address
2640 Milton Ave
Janesville, WI 53545-0231
Phone
(608) 755-1475
Fax
(608) 755-1733
NPI assigned
Apr 18, 2008
Last updated
Apr 18, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
JANESVILLE PSYCHIATIC CLINIC MAIN INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 18, 2008

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

Authorized official

Name
Mr. William Hollingsworth
Title
Director/Owner
Phone
(608) 755-1475

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 1448 WI Primary

Addresses

Primary practice location

2640 Milton Ave
Janesville, WI 53545-0231

Mailing address

2640 Milton Ave
Janesville, WI 53545-0231
Phone (608) 755-1475

Other identifiers 1

IdentifierTypeStateIssuer
43007200MedicaidWI

National Provider Directory

National Provider Directory
Tax ID family
Janesville Psychiatric Clinic Main Inc3 organizations share this tax ID, including this one
Part of
Janesville Psychiatric Clinic Main Inc

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1208476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208476800000",
    "number": "1578737706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2640 MILTON AVE",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535450231",
            "telephone_number": "608-755-1475",
            "fax_number": "608-755-1733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2640 MILTON AVE",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535450231",
            "telephone_number": "608-755-1475",
            "fax_number": "608-755-1733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JANESVILLE PSYCHIATRIC CLINIC DAYTREATMENT FOR CHILDREN",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JANESVILLE PSYCHIATIC CLINIC MAIN INC",
        "enumeration_date": "2008-04-18",
        "last_updated": "2008-04-18",
        "status": "A",
        "authorized_official_last_name": "HOLLINGSWORTH",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "DIRECTOR/OWNER",
        "authorized_official_telephone_number": "608-755-1475",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "1448",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43007200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Janesville, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2008; 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.