NPIMap

Organization Active NPI

Family Service Madison Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Madison, WI
National Provider Identifier
1881806198
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
FAMILY SERVICE MADISON INC
Practice address
128 E Olin Ave
Suite 100
Madison, WI 53713-1467
Phone
(608) 316-1186
Fax
(608) 252-1333
NPI assigned
May 7, 2007
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Ms. Brigid Okeefe
Title
Credential Coordinator
Phone
(608) 316-1186

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X WI Primary

Addresses

Primary practice location

128 E Olin Ave
Suite 100
Madison, WI 53713-1467

Mailing address

128 E Olin Ave
Suite 100
Madison, WI 53713-1467
Phone (608) 316-1186

Other identifiers 2

IdentifierTypeStateIssuer
42106700MedicaidWI
43006500MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040618000961 WI Part B Supplier - Clinic/Group Practice 5799760476 Receives reassigned benefits from 7 practitioners
Practice locations: Madison, WI

National Provider Directory

National Provider Directory

Locations

128 E Olin Ave
Ste 100
Madison, WI 53713
Phone (608) 252-1320

Practitioners & affiliated clinicians

Practitioners 78

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.

View all 78

NPI Registry JSON

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1881806198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 E OLIN AVE",
            "address_2": "SUITE 100",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537131467",
            "telephone_number": "608-316-1186",
            "fax_number": "608-252-1333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 E OLIN AVE",
            "address_2": "SUITE 100",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537131467",
            "telephone_number": "608-316-1186",
            "fax_number": "608-252-1333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY SERVICE MADISON INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-07",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "OKEEFE",
        "authorized_official_first_name": "BRIGID",
        "authorized_official_title_or_position": "CREDENTIAL COORDINATOR",
        "authorized_official_telephone_number": "608-316-1186",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42106700",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43006500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.