Organization
MCPST MANAGEMENT CORPORATION
Active
Other names
MIDWEST CTR FOR PSYCHOTHERAPY & SEX THERAPY
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JENNIFER WILGOCKI MS (CORPORATION PRESIDENT)
(608) 237-8000
Entity
Organization
Contact information
Practice address
6300 UNIVERSITY AVE, SUITE 125, MIDDLETON, WI 53562-3463
(608) 237-8000
(608) 237-8005
Mailing address
6300 UNIVERSITY AVE, SUITE 125, MIDDLETON, WI 53562-3463
(608) 237-8000
(608) 237-8005
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42172000
—
WI
Enumeration date
06/09/2006
Last updated
09/30/2014
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