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Organization
THEDACARE, INCORPORATED
Active
Organization
THEDACARE, INCORPORATED
Active
Other names
ThedaCare Behavioral Health
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM FLETT (CFO)
(920) 454-4013
Entity
Organization
Contact information
Practice address
1095 MIDWAY RD, MENASHA, WI 54952-1115
(920) 720-2300
Mailing address
3 NEENAH CTR, NEENAH, WI 54956-3070
(920) 830-5900
(920) 830-5910
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
103G00000X
Clinical Neuropsychologist
—
—
103T00000X
Psychologist
—
—
104100000X
Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
21277600
—
WI
05
—
42185300
—
WI
05
—
42186500
—
WI
05
—
42189600
—
WI
05
—
42213400
—
WI
Enumeration date
08/15/2006
Last updated
01/02/2024
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