Wade Koski LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

WADE KOSKI LLC

Practice address

4402 S 68TH St
Suite #100
Greenfield, WI 53220-3479

Phone

(414) 467-2477

Fax

(414) 321-0552

NPI assigned

Sep 15, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Wade Koski, LCSW

Title

Member

Phone

(414) 467-2477

Specialties & licenses 2

Addresses

Other identifiers 1

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

{
    "created_epoch": "1410739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410739200000",
    "number": "1992106595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4402 S 68TH ST",
            "address_2": "SUITE #100",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532203479",
            "telephone_number": "414-467-2477",
            "fax_number": "414-321-0552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4402 S 68TH ST",
            "address_2": "SUITE #100",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532203479",
            "telephone_number": "414-467-2477",
            "fax_number": "414-321-0552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WADE KOSKI LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-15",
        "last_updated": "2014-09-15",
        "status": "A",
        "authorized_official_last_name": "KOSKI",
        "authorized_official_first_name": "WADE",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "414-467-2477",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40959600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathleen Laney Vogt, LCSW
• Michael Vokes, PTA
• Carrie Lynn Voss, APNP
• Theresa Lynn Voster, OTR
• Melissa Vukovich, NP
• Michelle J Wadewitz, AU.D.
• Scott J Wagenknecht, DC
• Alexander Waites, LPC-IT
• Wal-Mart Stores East LP
• Wal-Mart Stores East LP

• All providers in Greenfield, WI
• Adult Mental Health Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2014; 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.