Provider Demographics
NPI:1497961551
Name:CONNECTIONS COUNSELING, LLC
Entity Type:Organization
Organization Name:CONNECTIONS COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:W
Authorized Official - Last Name:CALLENDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-233-2100
Mailing Address - Street 1:5005 UNIVERSITY AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53705-5400
Mailing Address - Country:US
Mailing Address - Phone:608-233-2100
Mailing Address - Fax:608-233-2101
Practice Address - Street 1:5005 UNIVERSITY AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53705-5400
Practice Address - Country:US
Practice Address - Phone:608-233-2100
Practice Address - Fax:608-221-1515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2015-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WIHFS 75.13101YA0400X
WIHFS 61.91101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI=========Medicare UPIN
WI=========OtherCSAS-OUTPATIENT TREATMENT