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 288 of 335 Certification Number/ Certified Provider's Main Site/ Email/Telephone 1885 STRESS MANAGEMENT AND MENTAL HEALTH CLINICS CRAIG MODELL 10201 W LINCOLN AVENUE, #308 WEST ALLIS, WI 53227 County: Milwaukee stressmang@hotmail.com Phone: (414) 329-7000 Fax: (414) 329-7010 Surveyor: Demetrius Anderson Services Community Substance Abuse and Mental Health Program Certification Directory By Provider Name & Certification Number Initial Certification/ Certification Effective/ Certification Expires 06/01/1980 06/01/2011 05/31/2013 Mental Health Outpatient Clinic DHS 35 1889 SUBURBAN COUNSELING SERVICES, LLC LAURA CAMPBELL PHD 13965 W. BURLEIGH ROAD, # 103 BROOKFIELD, WI 53005 County: Waukesha drcampbell@suburbancounseling.com Phone: (414) 550-9350 Fax: (262) 785-1409 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 STRESS MANAGEMENT & MENTAL HEALTH CLINICS N116 W16150 MAIN STREET GERMANTOWN, WI 53022 Tier 1 06/01/2011 05/31/2013 Administrative Code Chapter Service Begin/End Dates 08/01/1987 10/15/2011 12/31/2012 Mental Health Outpatient Clinic DHS 35 2751 SUE HUBER & ASSOCIATES, SC SUE HUBER 1039 W MASON STREET GREEN BAY, WI 54303 County: Brown No Email Address Provided Phone: (920) 496-3130 Fax: No Number Provided Surveyor: Frank Bellaire Services NO BRANCH LOCATIONS 06/01/2011 05/31/2013 Administrative Code Chapter Service Begin/End Dates 09/11/2007 10/01/2008 09/30/2009 Mental Health-Outpatient DHS 61.91 NO BRANCH LOCATIONS 10/15/2011 12/31/2012 Administrative Code Chapter Service Begin/End Dates 10/01/2008 09/30/2009
DEPARTMENT OF HEALTH SERVICES Division of Quality Assurance Print Date: 08/28/2012 Page 289 of 335 Certification Number/ Certified Provider's Main Site/ Email/Telephone 2216 SUE SITTLER NELSON, MSW PSYCHOTHERAPY ASSOCIATES SUE SITTLER NELSON 316 N 96TH STREET, #302 MILWAUKEE, WI 53202 County: Milwaukee sue.sittler.nelson@aurora.org Phone: (414) 765-0665 Fax: (414) 321-3519 Surveyor: Demetrius Anderson Services Community Substance Abuse and Mental Health Program Certification Directory By Provider Name & Certification Number Initial Certification/ Certification Effective/ Certification Expires 04/14/2000 05/01/2008 04/30/2010 Mental Health-Outpatient DHS 61.91 2238 SUMMIT PSYCHOLOGY CLINIC, SC JEANNE HERZOG 933 N. MAYFAIR ROAD, #303 WAUWATOSA, WI 53226 County: Milwaukee dan@viewthesummit.com Phone: (414) 258-8488 Fax: (414) 258-8838 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 08/24/2000 09/01/2009 08/31/2011 Mental Health Outpatient Clinic DHS 35 1408 SYNERGY GROUP OF EAU CLAIRE, SC DBA HEINZ PSYCHOLOGICAL SERVICES, LTD., S.C. MARK BJERKE 826 S. HASTINGS WAY EAU CLAIRE, WI 54701 County: Eau Claire viv@heinzpsych.com Phone: (715) 834-3171 Fax: (715) 834-3174 Surveyor: Polly Wong Services NO BRANCH LOCATIONS 05/01/2008 04/30/2010 Administrative Code Chapter Service Begin/End Dates 08/01/1990 09/01/2012 08/31/2014 Mental Health Outpatient Clinic DHS 35 CSAS-Outpatient Treatment DHS 75.13 SYNERGY OF EC, DBA HEINZ PSYCH SERVICES 420 S BARSTOW STREET, #3 EAU CLAIRE, WI 54701 09/01/2009 08/31/2011 Tier 2 09/01/2012 08/31/2014 Administrative Code Chapter Service Begin/End Dates 09/01/2012 08/31/2014 09/01/2012 08/31/2014
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Mental Health and Substance Abuse Programs in alphabetical

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