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 242 of 335<br />
Certification Number/<br />
Certified Provider's Ma<strong>in</strong> Site/<br />
Email/Telephone<br />
2929<br />
POWER FOR CHANGE, LLC<br />
STEVE SHEFCHIK<br />
1039 W MASON STREET<br />
GREEN BAY, WI 54303<br />
County: Brown<br />
sasmagic@sbcglobal.net<br />
Phone: (290) 965-7707<br />
Fax: (920) 496-7922<br />
Surveyor: Frank Bellaire<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 />
10/13/2010<br />
11/01/2011<br />
10/31/2012<br />
<strong>Mental</strong> <strong>Health</strong> Outpatient Cl<strong>in</strong>ic DHS 35<br />
1741<br />
POYNETTE COUNSELING & PSYCHOTHERAPY<br />
ASSOCIATES, INC.<br />
LORI A GOESER<br />
415 N. MAIN STREET, #3<br />
POYNETTE, WI 53955<br />
County: Columbia<br />
lori.goeser@poynettecounsel<strong>in</strong>g.com<br />
Phone: (608) 635-2146<br />
Fax: (608) 635-7379<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 />
07/01/1989<br />
12/01/2011<br />
11/30/2013<br />
<strong>Mental</strong> <strong>Health</strong> Outpatient Cl<strong>in</strong>ic DHS 35<br />
CSAS-Outpatient Treatment DHS 75.13<br />
1742<br />
PRAIRIE COUNSELING SERVICES<br />
KATHRYN HUBBARD<br />
1460 W. MAIN STREET #6<br />
SUN PRAIRIE, WI 53590<br />
County: Dane<br />
prairiec@netzero.net<br />
Phone: (608) 837-4814<br />
Fax: (608) 825-4933<br />
Surveyor: William Rohner<br />
Services<br />
11/01/2011 10/31/2012<br />
MAUSTON COUNSELING Tier 1<br />
1040 DIVISION STREET<br />
12/01/2011<br />
MAUSTON, WI 53948<br />
11/30/2013<br />
POYNETTE COUNSELING &<br />
PSYCHOTHERAPY ASSO<br />
Tier 1<br />
4915 MONONA DR<br />
12/01/2011<br />
MADISON, WI 53716<br />
11/30/2013<br />
Adm<strong>in</strong>istrative<br />
Code Chapter Service Beg<strong>in</strong>/End Dates<br />
07/01/1978<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 />
NO BRANCH LOCATIONS<br />
12/01/2011 11/30/2013<br />
12/01/2011 11/30/2013<br />
Adm<strong>in</strong>istrative<br />
Code Chapter Service Beg<strong>in</strong>/End Dates<br />
08/01/2012 07/31/2013<br />
08/01/2012 07/31/2013
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