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 248 of 335<br />
Certification Number/<br />
Certified Provider's Ma<strong>in</strong> Site/<br />
Email/Telephone<br />
1761<br />
PSYCHOLOGICAL AND COUNSELING SERVICES<br />
DR JEFFREY ADAMCZAK<br />
6929 MARINER DRIVE, #D<br />
RACINE, WI 53406<br />
County: Rac<strong>in</strong>e<br />
drjeffpsy@yahoo.com<br />
Phone: (262) 886-3322<br />
Fax: (262) 571-9648<br />
Surveyor: Mark Isaacs<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 />
08/15/1992<br />
09/01/2009<br />
08/31/2011<br />
<strong>Mental</strong> <strong>Health</strong> Outpatient Cl<strong>in</strong>ic DHS 35<br />
2806<br />
PSYCHOLOGICAL RESOURCE CENTER, LLC<br />
ELIZABETH K MCCLUSKEY<br />
1218 N 4TH STREET, #108<br />
TOMAHAWK, WI 54487<br />
County: L<strong>in</strong>coln<br />
laura@pscyhresctr.com<br />
Phone: (715) 224-2100<br />
Fax: (715) 224-2106<br />
Surveyor: Bradley Jahr<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 />
PSYCHOLOGICAL AND COUNSELING<br />
SERVICES<br />
8825 S HOWELL AVENUE, #301<br />
OAK CREEK, WI 53154<br />
PSYCHOLOGICAL AND COUNSELING<br />
SERVICES<br />
8405 - 104TH AVENUE<br />
PLEASANT PRAIRIE, WI 53158<br />
PSYCHOLOGICAL AND COUNSELING<br />
SERVICES<br />
7300 S 13TH STREET, #201<br />
OAK CREEK, WI 53154<br />
PSYCHOLOGICAL AND COUNSELING<br />
SERVICES<br />
919 - 60TH STREET<br />
KENOSHA, WI 53140<br />
Tier 1<br />
09/01/2009<br />
01/02/2010<br />
Tier 1<br />
01/03/2010<br />
08/31/2011<br />
Tier 1<br />
01/03/2010<br />
08/31/2011<br />
Tier 1<br />
09/01/2009<br />
01/02/2010<br />
Adm<strong>in</strong>istrative<br />
Code Chapter Service Beg<strong>in</strong>/End Dates<br />
10/01/2008<br />
10/01/2010<br />
09/30/2012<br />
<strong>Mental</strong> <strong>Health</strong> Outpatient Cl<strong>in</strong>ic DHS 35<br />
1766<br />
PSYCHOLOGY ASSOCIATES OF MADISON, LLP<br />
LYNN CATLIN, PHD<br />
122 E. OLIN AVENUE, #220<br />
MADISON, WI 53713<br />
County: Dane<br />
lynn.catl<strong>in</strong>@gmail.com<br />
Phone: (608) 255-9119<br />
Fax: (608) 255-9219<br />
Surveyor: William Rohner<br />
Services<br />
NO BRANCH LOCATIONS<br />
09/01/2009 08/31/2011<br />
Adm<strong>in</strong>istrative<br />
Code Chapter Service Beg<strong>in</strong>/End Dates<br />
07/01/1991<br />
07/01/2012<br />
06/30/2014<br />
<strong>Mental</strong> <strong>Health</strong> Outpatient Cl<strong>in</strong>ic DHS 35<br />
NO BRANCH LOCATIONS<br />
10/01/2010 09/30/2012<br />
Adm<strong>in</strong>istrative<br />
Code Chapter Service Beg<strong>in</strong>/End Dates<br />
07/01/2012 06/30/2014