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 80 of 335<br />
Certification Number/<br />
Certified Provider's Ma<strong>in</strong> Site/<br />
Email/Telephone<br />
1260<br />
CREATIVE CONSULTING AND COUNSELING<br />
SERVICES<br />
DR JIM MORNINGSTAR<br />
4200 W GOOD HOPE ROAD<br />
MILWAUKEE, WI 53209<br />
County: Milwaukee<br />
jim@transformationsusa.com<br />
Phone: (414) 351-5770<br />
Fax: (414) 351-5760<br />
Surveyor: Demetrius Anderson<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 />
02/01/1984<br />
03/01/2012<br />
02/28/2014<br />
<strong>Mental</strong> <strong>Health</strong> Outpatient Cl<strong>in</strong>ic DHS 35<br />
1262<br />
CREDENCE THERAPY ASSOCIATES<br />
DANIEL BISHOP<br />
1-1/2 W. GENEVA STREET<br />
ELKHORN, WI 53121<br />
County: Walworth<br />
ctamanager@credencetherapy.org<br />
Phone: (262) 723-3424<br />
Fax: (262) 723-8308<br />
Surveyor: William Rohner<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 />
CREATIVE CONSULTING & COUNSELING<br />
SEVICES<br />
2728 N PROSPECT<br />
MILWAUKEE, WI 53211<br />
Tier 1<br />
03/01/2012<br />
02/28/2014<br />
Adm<strong>in</strong>istrative<br />
Code Chapter Service Beg<strong>in</strong>/End Dates<br />
12/19/1995<br />
12/01/2011<br />
11/30/2012<br />
<strong>Mental</strong> <strong>Health</strong> Outpatient Cl<strong>in</strong>ic DHS 35<br />
CSAS-Outpatient Treatment DHS 75.13<br />
2868<br />
CROSSROADS COUNSELING CENTER - CHILD<br />
DAY TREATMENT<br />
TIM PERRY<br />
778 LOIS DRIVE<br />
SUN PRAIRIE, WI 53590<br />
County: Dane<br />
tperry@crossroads73.com<br />
Phone: (608) 208-6133<br />
Fax: (608) 755-5267<br />
Surveyor: William Rohner<br />
Services<br />
NO BRANCH LOCATIONS<br />
03/01/2012 02/28/2014<br />
Adm<strong>in</strong>istrative<br />
Code Chapter Service Beg<strong>in</strong>/End Dates<br />
08/18/2009<br />
09/01/2010<br />
08/31/2012<br />
<strong>Mental</strong> <strong>Health</strong>-Day Treatment for Children 1 DHS 40.11(2)(a)<br />
NO BRANCH LOCATIONS<br />
12/01/2011 11/30/2012<br />
12/01/2011 11/30/2012<br />
Adm<strong>in</strong>istrative<br />
Code Chapter Service Beg<strong>in</strong>/End Dates<br />
09/01/2010 08/31/2012
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