Provider Demographics
NPI:1477544732
Name:MENTAL HEALTH SERVICE FOR WOMEN AND FAMILIES
Entity Type:Organization
Organization Name:MENTAL HEALTH SERVICE FOR WOMEN AND FAMILIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:F
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:MA, MFT
Authorized Official - Phone:608-221-4030
Mailing Address - Street 1:715 HILL ST
Mailing Address - Street 2:#160
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53705-3542
Mailing Address - Country:US
Mailing Address - Phone:608-256-0942
Mailing Address - Fax:608-221-1143
Practice Address - Street 1:715 HILL ST
Practice Address - Street 2:#160
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53705-3542
Practice Address - Country:US
Practice Address - Phone:608-256-0942
Practice Address - Fax:608-221-1143
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI24-124106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty