Madison Mental Health Services
Organization Active NPI Mental Health Counselor · Madison, WI
NPI 1912004516 · NPPES record last updated Jan 28, 2015
Key facts
- NPI
- 1912004516
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 91-123 (WI)
- Legal business name
- MADISON MENTAL HEALTH SERVICES
- Practice address
- 715 Hill St
Madison, WI 53705-3542 - Phone
- (608) 238-5535
- Fax
- (608) 238-7294
- NPI assigned
- Sep 18, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. James F McGloin Jr., PH.D., LCSW
- Title
- Executive Director
- Phone
- (608) 231-2008
Practitioners 2
-
James Francis McGloin Jr., PH.D.
-
Mary Paulette Moskoff, PHD LCSW
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080425000220 | WI | Part B Supplier - Clinic/Group Practice | 0143308536 |
Receives reassigned benefits from 2 practitioners Practice locations: Madison, WI |
National Provider Directory
Locations
2700 Marshall Ct
Ste 1
Madison, WI 53705
Phone (608) 238-5535
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor |
101YM0800X | 91-123 | WI | Yes |
Addresses
Primary practice location
715 Hill St
Madison, WI 53705-3542
Mailing address
702 N Blackhawk Ave
Ste 104
Madison, WI 53705-3357
Phone (608) 238-5535
Other names
- Satellite Office--715 Hill Street, Madison 53705
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All providers in Madison, WI · Mental Health Counselor in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 28, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.