Mental Health and Substance Abuse Programs in alphabetical
Mental Health and Substance Abuse Programs in alphabetical
Mental Health and Substance Abuse Programs in alphabetical
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DEPARTMENT OF HEALTH SERVICES<br />
Division of Quality Assurance<br />
Pr<strong>in</strong>t Date: 08/28/2012<br />
Page 22 of 335<br />
Certification Number/<br />
Certified Provider's Ma<strong>in</strong> Site/<br />
Email/Telephone<br />
1070<br />
ASSOCIATED PSYCHIATRIC & CONSULTING<br />
SERVICES<br />
TREVA LEUPOLD<br />
10425 W. NORTH AVENUE, #350<br />
WAUWATOSA, WI 53226<br />
County: Milwaukee<br />
No Email Address Provided<br />
Phone: (414) 259-9516<br />
Fax: No Number Provided<br />
Surveyor: Demetrius Anderson<br />
Services<br />
Community <strong>Substance</strong> <strong>Abuse</strong> <strong>and</strong> <strong>Mental</strong> <strong>Health</strong><br />
Program Certification Directory<br />
By Provider Name & Certification Number<br />
Initial Certification/<br />
Certification Effective/<br />
Certification Expires<br />
03/01/1978<br />
09/01/2009<br />
08/31/2011<br />
<strong>Mental</strong> <strong>Health</strong> Outpatient Cl<strong>in</strong>ic DHS 35<br />
1072<br />
ASSOCIATED THERAPIES<br />
JULAINE SIEWERT<br />
8989 N. PT. WASHINGTON RD #220<br />
MILWAUKEE, WI 53217<br />
County: Milwaukee<br />
msiewert1@wi.rr.com<br />
Phone: (414) 352-3336<br />
Fax: (414) 352-3928<br />
Surveyor: William Goehr<strong>in</strong>g<br />
Services<br />
STATE OF WISCONSIN<br />
Bureau of <strong>Health</strong> Services<br />
PO Box 2969<br />
Madison, WI 53701-2969<br />
Tier/<br />
Branch Beg<strong>in</strong>/<br />
Branch Location(s) End Dates<br />
NO BRANCH LOCATIONS<br />
Adm<strong>in</strong>istrative<br />
Code Chapter Service Beg<strong>in</strong>/End Dates<br />
04/01/1992<br />
04/01/2011<br />
03/31/2013<br />
<strong>Mental</strong> <strong>Health</strong> Outpatient Cl<strong>in</strong>ic DHS 35<br />
1075<br />
ASSOCIATES IN PSYCHOTHERAPY<br />
ELIZABETH MAGNUS<br />
1519 PRIMROSE LANE<br />
JANESVILLE, WI 53545<br />
County: Rock<br />
apcl<strong>in</strong>ic@choiceonemail.com<br />
Phone: (608) 752-7255<br />
Fax: (608) 752-6942<br />
Surveyor: William Rohner<br />
Services<br />
09/01/2009 08/31/2011<br />
ASSOCIATED THERAPIES Tier 1<br />
17160 W NORTH AVENUE<br />
04/01/2011<br />
BROOKFIELD, WI 53005<br />
03/31/2013<br />
Adm<strong>in</strong>istrative<br />
Code Chapter Service Beg<strong>in</strong>/End Dates<br />
08/01/1980<br />
06/01/2012<br />
05/31/2014<br />
<strong>Mental</strong> <strong>Health</strong> Outpatient Cl<strong>in</strong>ic DHS 35<br />
04/01/2011 03/31/2013<br />
ASSOCIATES IN PSYCHOTHERAPY Tier 1<br />
636 PARK STREET<br />
06/01/2012<br />
BELOIT, WI 53511<br />
05/31/2014<br />
Adm<strong>in</strong>istrative<br />
Code Chapter Service Beg<strong>in</strong>/End Dates<br />
06/01/2012 05/31/2014
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