Provider Demographics
NPI:1932279593
Name:NORTHSTAR PARTNERSHIP
Entity Type:Organization
Organization Name:NORTHSTAR PARTNERSHIP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:PATTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-270-1960
Mailing Address - Street 1:700 RAY O VAC DR STE 10
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53711-2480
Mailing Address - Country:US
Mailing Address - Phone:608-270-1960
Mailing Address - Fax:608-270-1965
Practice Address - Street 1:700 RAY O VAC DR STE 10
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53711-2480
Practice Address - Country:US
Practice Address - Phone:608-270-1960
Practice Address - Fax:608-270-1965
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2013-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1685101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI42209900Medicaid
WI44260Medicare ID - Type Unspecified