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RIVERWALK PSYCHOTHERAPY ASSOCIATES LLC NPI 1073687349


NPI Information

NPI: 1073687349
Provider Name: RIVERWALK PSYCHOTHERAPY ASSOCIATES, LLC

Former Legal Business Name: MIDWEST CENTER FOR HUMAN SERVICES

Classification: General Practice - 208D00000X
Entity Type: Organization
Address:
1110 N. OLD WORLD THIRD ST.
SUITE 401
MILWAUKEE, WI
ZIP 53203
Phone: (414) 224-0800
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RIVERWALK PSYCHOTHERAPY ASSOCIATES, LLC is a general practice in Milwaukee, WI. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee RIVERWALK PSYCHOTHERAPY ASSOCIATES, LLC NPI is 1073687349. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Former Legal Business Name Is Midwest Center For Human Services.

The provider's business location address is:

1110 N. OLD WORLD THIRD ST.
SUITE 401
MILWAUKEE, WI
ZIP 53203
Phone: (414) 224-0800
Fax: (414) 224-0883

The provider's authorized official is Serena Courtney Clardie .
The authorized official title is Partner/psychotherapist and has the following contact phone number (414) 224-0800.

The enumeration date for this NPI number is 11/20/2006 and was last updated on 6/10/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11041C0700XSocial WorkerClinicalNo
2208D00000XGeneral PracticeYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
142184700MEDICAIDWISCONSIN
284506MEDICARE ID-TYPE UNSPECIFIEDWISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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