Provider Demographics
NPI:1508960675
Name:COUNTY OF WINNEBAGO
Entity Type:Organization
Organization Name:COUNTY OF WINNEBAGO
Other - Org Name:WINNEBAGO COUNTY HUMAN SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:HUMAN SERVICES DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:W
Authorized Official - Last Name:TOPEL
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:920-236-4700
Mailing Address - Street 1:PO BOX 2187
Mailing Address - Street 2:
Mailing Address - City:OSHKOSH
Mailing Address - State:WI
Mailing Address - Zip Code:54903-2187
Mailing Address - Country:US
Mailing Address - Phone:920-236-4739
Mailing Address - Fax:920-424-7521
Practice Address - Street 1:220 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:OSHKOSH
Practice Address - State:WI
Practice Address - Zip Code:54901
Practice Address - Country:US
Practice Address - Phone:920-236-4739
Practice Address - Fax:920-424-7521
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-11
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
000084287OtherPROVIDER ID
WI42139300Medicaid
E70631Medicare UPIN
000084287OtherPROVIDER ID