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CHILDREN'S HOSPITAL OF WISCONSIN INC. NPI 1275961021


NPI Information

NPI: 1275961021
Provider Name: CHILDREN'S HOSPITAL OF WISCONSIN, INC.

Doing Business As: CHW PAIN AND HEADACHE CLINIC

Classification: Clinic/Center - 261QM0855X
Entity Type: Organization

Specialization: Adolescent and Children Mental Health

Address:
9000 W WISCONSIN AVE
PAIN CLINIC AND HEADACHE CLINIC
MILWAUKEE, WI
ZIP 53226
Phone: (414) 266-3133
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CHILDREN'S HOSPITAL OF WISCONSIN, INC. is an adolescent and children mental health clinic center in Milwaukee, WI. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. CHILDREN'S HOSPITAL OF WISCONSIN, INC. NPI is 1275961021. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Chw Pain And Headache Clinic.

The provider's business location address is:

9000 W WISCONSIN AVE
PAIN CLINIC AND HEADACHE CLINIC
MILWAUKEE, WI
ZIP 53226-874
Phone: (414) 266-3133
Fax: (414) 266-1761

The provider's authorized official is Weldon Gage .
The authorized official title is Treasurer/chief Financial Officer and has the following contact phone number (414) 266-6401.

The enumeration date for this NPI number is 10/14/2013 and was last updated on 9/25/2014.


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
1103T00000XPsychologist3186-57WISCONSINNo
2106H00000XMarriage & Family Therapist662-124WISCONSINNo
3261QM0855XClinic/CenterAdolescent and Children Mental HealthYes

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
11275961021MEDICAIDWISCONSIN

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: 11/14/2023

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