Organization
OAKWOOD CLINICAL ASSOCIATES, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY B ANDERSON MSW (PSYCHOTHERAPIST)
(262) 652-9830
Entity
Organization
Contact information
Practice address
4109 67TH ST, KENOSHA, WI 53142-3836
(262) 652-9830
(262) 652-2931
Mailing address
4109 67TH ST, KENOSHA, WI 53142-3836
(262) 652-9830
(262) 652-2931
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
WI
101YP2500X
Professional Counselor
—
WI
1041C0700X
Clinical Social Worker
—
WI
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42157000
—
WI
01
—
84521
MEDICARE
WI
Enumeration date
07/02/2006
Last updated
03/18/2015
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