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 306 of 335 Certification Number/ Certified Provider's Main Site/ Email/Telephone 1940 UNIVERSITY OF WI HOSPITALS & CLINICS CYNTHIA GREEN 122 E. OLIN AVENUE, #275 MADISON, WI 53713 County: Dane CGreen@uwhealth.org Phone: (608) 262-1111 Fax: (608) 263-9045 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 02/01/2012 01/31/2014 Mental Health Outpatient Clinic DHS 35 CSAS-Outpatient Treatment DHS 75.13 1953 UNIVERSITY OF WISCONSIN HOSPITALS AND CLINICS AUTHORITY JACKIE SMITH-HELMANSTEIN 600 HIGHLAND AVE, AOB-414 MADISON, WI 53792 County: Dane jSmith-Helmanstein@uwhealth.org Phone: (608) 821-4929 Fax: (608) 662-3050 Surveyor: William Rohner 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 01/01/1987 11/01/2011 10/31/2013 Mental Health-Inpatient DHS 61.71 1956 UPLANDS COUNSELING ASSOCIATES, INC. STEPHANIE KARWACKI 9 ODANA COURT, #203 MADISON, WI 53719 County: Dane ucamadison@tds.net Phone: (608) 274-5181 Fax: (608) 274-2848 Surveyor: William Rohner Services NO BRANCH LOCATIONS 02/01/2012 01/31/2014 02/01/2012 01/31/2014 Administrative Code Chapter Service Begin/End Dates 10/01/1994 10/01/2011 09/30/2013 Mental Health Outpatient Clinic DHS 35 NO BRANCH LOCATIONS 11/01/2011 10/31/2013 Administrative Code Chapter Service Begin/End Dates 10/01/2011 09/30/2013
DEPARTMENT OF HEALTH SERVICES Division of Quality Assurance Print Date: 08/28/2012 Page 307 of 335 Certification Number/ Certified Provider's Main Site/ Email/Telephone 1374 UW HEALTH - GATEWAY RECOVERY MICHAEL WAUPOOSE 25 KESSEL COURT, #200 MADISON, WI 53711 County: Dane michael.waupoose@uwmf.wisc.edu Phone: (608) 278-8200 Fax: (608) 278-8204 Surveyor: William Rohner Services Community Substance Abuse and Mental Health Program Certification Directory By Provider Name & Certification Number Initial Certification/ Certification Effective/ Certification Expires 01/01/1992 12/01/2010 11/30/2012 Mental Health Outpatient Clinic DHS 35 CSAS-Outpatient Treatment DHS 75.13 1278 UW HEALTH PARTNERS DIRECTIONS COUNSELING CENTER ERIC D BEAVER 129 HOSPITAL DRIVE WATERTOWN, WI 53098 County: Dodge ebeaver@uwhpwatertown.com Phone: (920) 262-4800 Fax: (920) 262-4813 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 11/01/1981 01/01/2012 12/31/2013 Mental Health Outpatient Clinic DHS 35 CSAS-Outpatient Treatment DHS 75.13 1961 VALENTIN CLINIC CYNTHIA VALENTIN 1220 DEWEY AVENUE WAUWATOSA, WI 53213 County: Milwaukee valentinclinic@sbcglobal.net Phone: (414) 454-6514 Fax: (414) 454-6751 Surveyor: Demetrius Anderson Services UW HEALTH PARTNERS LAKE MILLS CLINIC 1025 MULBERRY STREET LAKE MILLS, WI 53551 12/01/2010 11/30/2012 12/01/2010 11/30/2012 Tier 1 01/01/2012 12/31/2013 Administrative Code Chapter Service Begin/End Dates 03/01/1992 09/01/2011 08/31/2013 Mental Health Outpatient Clinic DHS 35 CSAS-Outpatient Treatment DHS 75.13 NO BRANCH LOCATIONS 01/01/2012 12/31/2013 01/01/2012 12/31/2013 Administrative Code Chapter Service Begin/End Dates 09/01/2011 08/31/2013 09/01/2011 08/31/2013
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Mental Health and Substance Abuse Programs in alphabetical

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