1790808269 NPI number — UNIVERSITY HEALTH AND COUNSELING SERVICES

Table of content: (NPI 1790808269)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790808269 NPI number — UNIVERSITY HEALTH AND COUNSELING SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNIVERSITY HEALTH AND COUNSELING SERVICES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
UNIVERSITY OF WISCONSIN - WHITEWATER
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1790808269
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
800 W MAIN ST
Provider Second Line Business Mailing Address:
UW-WHITEWATER
Provider Business Mailing Address City Name:
WHITEWATER
Provider Business Mailing Address State Name:
WI
Provider Business Mailing Address Postal Code:
53190-1705
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
262-472-1300
Provider Business Mailing Address Fax Number:
262-472-5608

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
800 W MAIN ST
Provider Second Line Business Practice Location Address:
UW-WHITEWATER
Provider Business Practice Location Address City Name:
WHITEWATER
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
53190-1705
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
262-472-1300
Provider Business Practice Location Address Fax Number:
262-472-5608
Provider Enumeration Date:
04/09/2007

Additional Information

Authorized Official

Authorized Official Last Name:
SWISHER
Authorized Official First Name:
RUTH
Authorized Official Middle Name:
Authorized Official Title or Position:
ASSOCIATE DIRECTOR
Authorized Official Telephone Number:
262-472-1300

Provider Taxonomy Codes

  • Taxonomy code: 261QS1000X , with the licence number:  2561033 , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QS1000X , with the licence number: 85167030 , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2561033 . This is a "APNP" identifier , issued by the state of ( WI ) . This identifiers is of the category "OTHER".
  • Identifier: 85167030 . This is a "R.N." identifier , issued by the state of ( WI ) . This identifiers is of the category "OTHER".




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