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 220 of 335<br />
Certification Number/<br />
Certified Provider's Ma<strong>in</strong> Site/<br />
Email/Telephone<br />
2361<br />
NORTHLAND COUNSELING SERVICES<br />
JEREMY KOEHL<br />
21 W OMAHA STREET<br />
WASHBURN, WI 54891<br />
County: Bayfield<br />
northl<strong>and</strong>006@centurytel.net<br />
Phone: (715) 373-0160<br />
Fax: (715) 373-0162<br />
Surveyor: Bradley Jahr<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 />
07/01/2001<br />
07/01/2012<br />
06/30/2014<br />
<strong>Mental</strong> <strong>Health</strong> Outpatient Cl<strong>in</strong>ic DHS 35<br />
CSAS-Outpatient Treatment DHS 75.13<br />
1695<br />
NORTHSHORE CLINIC & CONSULTANTS, INC.<br />
JOY MYERS<br />
W62 N248 WASHINGTON AVE., #207<br />
CEDARBURG, WI 53012<br />
County: Ozaukee<br />
joymyersnsc@yahoo.com<br />
Phone: (262) 375-1116<br />
Fax: (262) 375-1071<br />
Surveyor: Mark Isaacs<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 />
NORTHLAND COUNSELING SERVICES Tier 1<br />
611 E WALL STREET<br />
07/01/2012<br />
EAGLE RIVER, WI 54521<br />
06/30/2014<br />
NORTHLAND COUNSELING SERVICES Tier 1<br />
1619 WEST THIRD STREET<br />
07/01/2012<br />
ASHLAND, WI 54806<br />
06/30/2014<br />
Adm<strong>in</strong>istrative<br />
Code Chapter Service Beg<strong>in</strong>/End Dates<br />
10/01/1987<br />
08/01/2012<br />
07/31/2013<br />
<strong>Mental</strong> <strong>Health</strong> Outpatient Cl<strong>in</strong>ic DHS 35<br />
CSAS-Outpatient Treatment DHS 75.13<br />
1699<br />
NORTHSHORE CLINIC OF SHEBOYGAN, INC.<br />
SUE BALOG<br />
615 S. 8TH STREET, #G20<br />
SHEBOYGAN, WI 53081<br />
County: Sheboygan<br />
nsc@northshorecl<strong>in</strong>ic.org<br />
Phone: (920) 457-8866<br />
Fax: (920) 457-8867<br />
Surveyor: William Goehr<strong>in</strong>g<br />
Services<br />
07/01/2012 06/30/2014<br />
07/01/2012 06/30/2014<br />
NORTHSHORE CLINIC & CONSULTANTS Tier 1<br />
207 E BUFFALO STREET, #510<br />
08/01/2012<br />
MILWAUKEE, WI 53202<br />
07/31/2013<br />
NORTHSHORE CLINIC & CONSULTANTS Tier 2<br />
2363 S 102ND STREET, #203<br />
08/01/2012<br />
WEST ALLIS, WI 53227<br />
07/31/2013<br />
NORTHSHORE CLINIC & CONSULTANTS,<br />
INC<br />
Tier 2<br />
2607 N GRANDVIEW BLVD, #104<br />
08/01/2012<br />
WAUKESHA, WI 53188<br />
07/31/2013<br />
NORTHSHORE CLINIC & CONSULTANTS,<br />
INC.<br />
Tier 2<br />
1615 BARTON AVENUE<br />
08/01/2012<br />
WEST BEND, WI 53090<br />
07/31/2013<br />
Adm<strong>in</strong>istrative<br />
Code Chapter Service Beg<strong>in</strong>/End Dates<br />
08/01/1991<br />
08/01/2011<br />
07/31/2013<br />
<strong>Mental</strong> <strong>Health</strong> Outpatient Cl<strong>in</strong>ic DHS 35<br />
CSAS-Outpatient Treatment DHS 75.13<br />
NO BRANCH LOCATIONS<br />
08/01/2012 07/31/2013<br />
08/01/2012 07/31/2013<br />
Adm<strong>in</strong>istrative<br />
Code Chapter Service Beg<strong>in</strong>/End Dates<br />
08/01/2011 07/31/2013<br />
08/01/2011 07/31/2013
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