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Organization
WELLPOINT CARE NETWORK
Active
Organization
WELLPOINT CARE NETWORK
Active
Other names
SaintA
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JODY ANN PAHLAVAN PSY.D. (VICE PRESIDENT OF CLINICAL SERVICES)
(414) 463-1880
Entity
Organization
Contact information
Practice address
8901 W. CAPITOL DR, MILWAUKEE, WI 53222-1706
(414) 465-5751
(414) 463-2770
Mailing address
8901 W. CAPITOL DR, MILWAUKEE, WI 53222-1706
(414) 465-5751
(414) 463-2770
Taxonomy
Speciality
Code
Description
License number
State
225XM0800X
Mental Health Occupational Therapist
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
WI
261QR0400X
Rehabilitation Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100078122
—
WI
05
—
43016900
—
WI
Enumeration date
04/15/2008
Last updated
04/06/2023
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