Organization
RACINE PSYCHOLOGICAL SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY JANE WHITMORE LCSW, CSAC (DIRECTOR)
(262) 634-8688
Entity
Organization
Contact information
Practice address
840 LAKE AVE, SUITE 101, RACINE, WI 53403-1566
(262) 634-8688
(262) 634-7547
Mailing address
840 LAKE AVE, SUITE 101, RACINE, WI 53403-1566
(262) 634-8688
(262) 634-7547
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
2220
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42216900
—
WI
Enumeration date
05/18/2006
Last updated
04/20/2008
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