NPIMap

Organization Active NPI

Aadvantage Behavioral Healthcare, LLC

Doing business as Advantage Behavioral Healthcare, LLC

  • Clinical Social Worker
  • Lake Mills, WI
National Provider Identifier
1669602488
Registry record updated Jul 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6647-123 Issued in WI
Legal business name
AADVANTAGE BEHAVIORAL HEALTHCARE, LLC
Doing business as
Advantage Behavioral Healthcare, LLC
Practice address
125 E Pine St
Lake Mills, WI 53551-1103
Phone
(608) 843-4555
NPI assigned
Jul 15, 2009
Last updated
Jul 15, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2009

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

Authorized official

Name
Maureen Gale BussNPI 1578698130
Title
Executive Director
Phone
(608) 843-4555

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 2498 WI
Adult Mental Health Clinic/Center 261QM0850X 6647-123 WI
Adolescent and Children Mental Health Clinic/Center 261QM0855X 6647-123 WI
Clinical Social Worker 1041C0700X 6647-123 WI Primary

Addresses

Primary practice location

125 E Pine St
Lake Mills, WI 53551-1103

Mailing address

N6658 Woodfield LN
Lake Mills, WI 53551-9740
Phone (608) 843-4555

Other identifiers 1

IdentifierTypeStateIssuer
42236300MedicaidWI

Other names 1

  • Advantage Behavioral Healthcare, LLC Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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": "1247616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247616000000",
    "number": "1669602488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N6658 WOODFIELD LN",
            "city": "LAKE MILLS",
            "state": "WI",
            "postal_code": "535519740",
            "telephone_number": "608-843-4555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 E PINE ST",
            "city": "LAKE MILLS",
            "state": "WI",
            "postal_code": "535511103",
            "telephone_number": "608-843-4555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AADVANTAGE BEHAVIORAL HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-15",
        "last_updated": "2009-07-15",
        "status": "A",
        "authorized_official_last_name": "BUSS",
        "authorized_official_first_name": "MAUREEN",
        "authorized_official_middle_name": "GALE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "608-843-4555"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "WI",
            "license": "2498",
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "WI",
            "license": "6647-123",
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "WI",
            "license": "6647-123",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "6647-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42236300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advantage Behavioral Healthcare, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lake Mills, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2009; 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.