Active NPI
Innerchange, Inc.
- Mental Health Counselor
- Onalaska, WI
National Provider Identifier
1770634370
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 1435
- Legal business name
- INNERCHANGE, INC.
- Practice address
- 1401 Main St
Onalaska, WI 54650-2858 - Phone
- (608) 783-2186
- Fax
- (608) 781-3405
- NPI assigned
- Jan 12, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Thomas B Roberts, LCSW
- Title
- President
- Phone
- (608) 783-2186
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 1435 | WI | Primary |
Addresses
Primary practice location
1401 Main St
Onalaska, WI 54650-2858
Mailing address
1401 Main St
Onalaska, WI 54650-2858
Phone (608) 783-2186
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 42165700 | Medicaid | WI |
National Provider Directory
National Provider DirectoryLocations
1401 Main St
Onalaska, WI 54650
Phone (608) 783-2186
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Psychiatry Physician
- Viroqua, WI
- NPI 1710025804
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168560000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1236211200000",
"number": "1770634370",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1401 MAIN ST",
"city": "ONALASKA",
"state": "WI",
"postal_code": "546502858",
"telephone_number": "608-783-2186",
"fax_number": "608-781-3405"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1401 MAIN ST",
"city": "ONALASKA",
"state": "WI",
"postal_code": "546502858",
"telephone_number": "608-783-2186",
"fax_number": "608-781-3405"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "INNERCHANGE, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2007-01-12",
"last_updated": "2009-03-05",
"status": "A",
"authorized_official_last_name": "ROBERTS",
"authorized_official_first_name": "THOMAS",
"authorized_official_middle_name": "B",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "608-783-2186",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "LCSW"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Counselor, Mental Health",
"state": "WI",
"license": "1435",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "42165700",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Onalaska, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 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.