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 248 of 335 Certification Number/ Certified Provider's Main Site/ Email/Telephone 1761 PSYCHOLOGICAL AND COUNSELING SERVICES DR JEFFREY ADAMCZAK 6929 MARINER DRIVE, #D RACINE, WI 53406 County: Racine drjeffpsy@yahoo.com Phone: (262) 886-3322 Fax: (262) 571-9648 Surveyor: Mark Isaacs Services Community Substance Abuse and Mental Health Program Certification Directory By Provider Name & Certification Number Initial Certification/ Certification Effective/ Certification Expires 08/15/1992 09/01/2009 08/31/2011 Mental Health Outpatient Clinic DHS 35 2806 PSYCHOLOGICAL RESOURCE CENTER, LLC ELIZABETH K MCCLUSKEY 1218 N 4TH STREET, #108 TOMAHAWK, WI 54487 County: Lincoln laura@pscyhresctr.com Phone: (715) 224-2100 Fax: (715) 224-2106 Surveyor: Bradley Jahr Services STATE OF WISCONSIN Bureau of Health Services PO Box 2969 Madison, WI 53701-2969 Tier/ Branch Begin/ Branch Location(s) End Dates PSYCHOLOGICAL AND COUNSELING SERVICES 8825 S HOWELL AVENUE, #301 OAK CREEK, WI 53154 PSYCHOLOGICAL AND COUNSELING SERVICES 8405 - 104TH AVENUE PLEASANT PRAIRIE, WI 53158 PSYCHOLOGICAL AND COUNSELING SERVICES 7300 S 13TH STREET, #201 OAK CREEK, WI 53154 PSYCHOLOGICAL AND COUNSELING SERVICES 919 - 60TH STREET KENOSHA, WI 53140 Tier 1 09/01/2009 01/02/2010 Tier 1 01/03/2010 08/31/2011 Tier 1 01/03/2010 08/31/2011 Tier 1 09/01/2009 01/02/2010 Administrative Code Chapter Service Begin/End Dates 10/01/2008 10/01/2010 09/30/2012 Mental Health Outpatient Clinic DHS 35 1766 PSYCHOLOGY ASSOCIATES OF MADISON, LLP LYNN CATLIN, PHD 122 E. OLIN AVENUE, #220 MADISON, WI 53713 County: Dane lynn.catlin@gmail.com Phone: (608) 255-9119 Fax: (608) 255-9219 Surveyor: William Rohner Services NO BRANCH LOCATIONS 09/01/2009 08/31/2011 Administrative Code Chapter Service Begin/End Dates 07/01/1991 07/01/2012 06/30/2014 Mental Health Outpatient Clinic DHS 35 NO BRANCH LOCATIONS 10/01/2010 09/30/2012 Administrative Code Chapter Service Begin/End Dates 07/01/2012 06/30/2014
DEPARTMENT OF HEALTH SERVICES Division of Quality Assurance Print Date: 08/28/2012 Page 249 of 335 Certification Number/ Certified Provider's Main Site/ Email/Telephone 1410 PSYCHOTHERAPY AND GROWTH CENTER TAMARA SCHLESSINGER 660 W WASHINGTON, #307 MADISON, WI 53703 County: Dane No Email Address Provided Phone: (608) 255-0669 Fax: (608) 255-0667 Surveyor: William Rohner Services Community Substance Abuse and Mental Health Program Certification Directory By Provider Name & Certification Number Initial Certification/ Certification Effective/ Certification Expires 11/01/1990 11/01/2009 10/31/2011 Mental Health Outpatient Clinic DHS 35 2236 QAM - QUALITY ADDICTION MANAGEMENT CHARLES ENGEL 1610 MILLER PARKWAY WEST MILWAUKEE, WI 53214 County: Milwaukee No Email Address Provided Phone: (414) 672-3804 Fax: (414) 672-6026 Surveyor: Mark Isaacs 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 06/19/2000 09/01/2010 08/31/2012 CSAS-Narcotic Treatment DHS 75.15 CSAS-Outpatient Treatment DHS 75.13 1748 QAM-QUALITY ADDICTION MANAGEMENT ELIZABETH GILBERT 2422 N. GRANDVIEW BOULEVARD WAUKESHA, WI 53188 County: Waukesha egilbert@qam-inc.com Phone: (262) 549-6600 Fax: (262) 549-6698 Surveyor: Mark Isaacs Services NO BRANCH LOCATIONS 11/01/2009 10/31/2011 Administrative Code Chapter Service Begin/End Dates 04/01/1994 09/01/2010 08/31/2012 CSAS-Narcotic Treatment DHS 75.15 CSAS-Outpatient Treatment DHS 75.13 NO BRANCH LOCATIONS 09/01/2010 08/31/2012 09/01/2010 08/31/2012 Administrative Code Chapter Service Begin/End Dates 09/01/2010 08/31/2012 09/01/2010 08/31/2012
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Mental Health and Substance Abuse Programs in alphabetical

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