PSYCHOLOGICAL ADDICTION SERVICES LLC NPI 1881131761

NPI Information

NPI: 1881131761
Provider Name: PSYCHOLOGICAL ADDICTION SERVICES LLC
Classification: Clinic/Center - 261QM2800X
Entity Type: Organization

Specialization: Methadone

CLIA Number: 52D2128477

Address:
3113 E WASHINGTON AVE
MADISON, WI
ZIP 53704
Phone: (608) 416-5777
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PSYCHOLOGICAL ADDICTION SERVICES LLC is a methadone clinic center in Madison, WI. The provider is an entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction. PSYCHOLOGICAL ADDICTION SERVICES LLC NPI is 1881131761. The provider is registered as an organization entity type.

The provider's business location address is:

3113 E WASHINGTON AVE
MADISON, WI
ZIP 53704-330
Phone: (608) 416-5777
Fax: (608) 416-5776

The provider's authorized official is Donald A Zukowski .
The authorized official title is President and has the following contact phone number (608) 225-8954.

The CLIA number assigned to this NPI record is 52D2128477 - independent with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 1/30/2017 and was last updated on 10/8/2018.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM2800X	Clinic/Center	Methadone			Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	=========	MEDICAID	WISCONSIN

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

NPI Synchronization or Removal

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