Provider Demographics
NPI:1144702499
Name:CATHOLIC CHARITIES INC., DIOCESE OF MADISON
Entity type:Organization
Organization Name:CATHOLIC CHARITIES INC., DIOCESE OF MADISON
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:LCSW
Authorized Official - Prefix:MISS
Authorized Official - First Name:MERCY
Authorized Official - Middle Name:M
Authorized Official - Last Name:GREENWALD
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:608-826-8010
Mailing Address - Street 1:702 S HIGH POINT RD STE 105
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53719-4926
Mailing Address - Country:US
Mailing Address - Phone:608-826-8011
Mailing Address - Fax:608-826-8027
Practice Address - Street 1:615 E WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53703-2952
Practice Address - Country:US
Practice Address - Phone:608-826-8010
Practice Address - Fax:608-826-8027
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-04
Last Update Date:2018-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI8665-123101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty