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Organization

PROFESSIONAL SERVICES GROUP, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JONATHAN GRAPENGIESER PSYD (CLINICAL DIRECTOR)
(262) 654-1004
Entity
Organization

Contact information

Practice address
2108 63RD ST, KENOSHA, WI 53143-4454
(262) 652-2406
(262) 654-6960
Mailing address
6233 39TH AVE, KENOSHA, WI 53142-7015
(262) 654-1004
(262) 654-6960

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
42125700
WI
Enumeration date
01/05/2007
Last updated
06/13/2025
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