Mental Health and Substance Abuse Programs in alphabetical

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DEPARTMENT OF HEALTH SERVICES Division of Quality Assurance Print Date: 08/28/2012 Page 236 of 335 Certification Number/ Certified Provider's Main Site/ Email/Telephone 2248 PATHWAYS CONSULTING SHARON O'BRIEN 6121 GREEN BAY ROAD, #220 KENOSHA, WI 53142 County: Kenosha No Email Address Provided Phone: (262) 652-7222 Fax: (262) 652-1734 Surveyor: Mark Isaacs Services Community Substance Abuse and Mental Health Program Certification Directory By Provider Name & Certification Number Initial Certification/ Certification Effective/ Certification Expires 09/06/2000 09/01/2009 08/31/2011 Mental Health Outpatient Clinic DHS 35 1730 PATHWAYS COUNSELING CENTER SALLY TARVID 13105 W. BLUEMOUND ROAD, #100 BROOKFIELD, WI 53005 County: Waukesha pathwaycc@sbcglobal.net Phone: (262) 641-9790 Fax: (262) 641-9791 Surveyor: Demetrius Anderson Services STATE OF WISCONSIN Bureau of Health Services PO Box 2969 Madison, WI 53701-2969 Tier/ Branch Begin/ Branch Location(s) End Dates NO BRANCH LOCATIONS Administrative Code Chapter Service Begin/End Dates 12/01/1985 02/01/2012 01/31/2014 Mental Health Outpatient Clinic DHS 35 2792 PEACE TREE COUNSELING, LLC VALERIE ZELLMER 204 THIRD AVENUE OSCEOLA, WI 54020 County: Polk peacetree@centurytel.net Phone: (715) 755-2233 Fax: (715) 755-3966 Surveyor: Polly Wong Services NO BRANCH LOCATIONS 09/01/2009 08/31/2011 Administrative Code Chapter Service Begin/End Dates 06/24/2008 06/01/2011 05/31/2013 Mental Health Outpatient Clinic DHS 35 NO BRANCH LOCATIONS 02/01/2012 01/31/2014 Administrative Code Chapter Service Begin/End Dates 06/01/2011 05/31/2013
DEPARTMENT OF HEALTH SERVICES Division of Quality Assurance Print Date: 08/28/2012 Page 237 of 335 Certification Number/ Certified Provider's Main Site/ Email/Telephone 2715 PEACEFUL SOLUTIONS COUNSELING LEE SHIPWAY 1720 MERRILL AVENUE, #300 WAUSAU, WI 54401 County: Marathon lee@peacefulsolutions.org Phone: (715) 675-3458 Fax: (715) 675-7238 Surveyor: Bradley Jahr Services Community Substance Abuse and Mental Health Program Certification Directory By Provider Name & Certification Number Initial Certification/ Certification Effective/ Certification Expires 03/01/2007 03/01/2012 02/28/2014 Mental Health Outpatient Clinic DHS 35 2923 PENFIELD CHILDREN'S CENTER HEATHER ROTOLO 833 N 26TH STREET MILWAUKEE, WI 53233 County: Milwaukee heatherrotolo@penfieldchildren.org Phone: (414) 345-6337 Fax: (414) 344-7739 Surveyor: William Goehring Services STATE OF WISCONSIN Bureau of Health Services PO Box 2969 Madison, WI 53701-2969 Tier/ Branch Begin/ Branch Location(s) End Dates NO BRANCH LOCATIONS Administrative Code Chapter Service Begin/End Dates 10/01/2010 10/01/2011 09/30/2013 Mental Health Outpatient Clinic DHS 35 1733 PERFORMANCE ENHANCEMENT HEALTH SERVICES, SC JODI PETERNEL 8800 W 102ND STREET #103 FRANKLIN, WI 53132 County: Milwaukee pepetjodi@hotmail.com Phone: (414) 858-1014 Fax: (414) 858-1017 Surveyor: Demetrius Anderson Services NO BRANCH LOCATIONS 03/01/2012 02/28/2014 Administrative Code Chapter Service Begin/End Dates 03/11/1991 02/01/2012 01/31/2014 Mental Health Outpatient Clinic DHS 35 Mental Health Outpatient Clinic with Telehealth DHS 35 PERFORMANCE ENHANCEMENT HEALTH SERVICES SC 7418 TICHIGAN ROAD WATERFORD, WI 53185 10/01/2011 09/30/2013 Tier 1 02/01/2012 01/31/2014 Administrative Code Chapter Service Begin/End Dates 02/01/2012 01/31/2014 02/01/2012 01/31/2014
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Mental Health and Substance Abuse Programs in alphabetical

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