Organization
PSYCHIATRIC SERVICES SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES JAMES HODULIK MD (PRESIDENT)
(608) 238-9354
Entity
Organization
Contact information
Practice address
2727 MARSHALL CT, MADISON, WI 53705-2255
(608) 238-9354
(608) 238-7675
Mailing address
2727 MARSHALL CT, MADISON, WI 53705-2255
(608) 238-9354
(608) 238-7675
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
1064-057
WI
103TC0700X
Clinical Psychologist
1898-057
WI
103TC0700X
Clinical Psychologist
1993-057
WI
103TC0700X
Clinical Psychologist
2155-057
WI
103TC0700X
Clinical Psychologist
2284-057
WI
103TC1900X
Counseling Psychologist
920-057
WI
1041C0700X
Clinical Social Worker
1085-123
WI
1041C0700X
Clinical Social Worker
3257-123
WI
1041C0700X
Clinical Social Worker
391-123
WI
1041C0700X
Clinical Social Worker
504-123
WI
1041C0700X
Clinical Social Worker
522-123
WI
1041C0700X
Clinical Social Worker
7213-123
WI
2084P0800X
Psychiatry Physician
22400-020
WI
2084P0800X
Psychiatry Physician
Primary
41061-021
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42141600
—
WI
Enumeration date
08/14/2007
Last updated
07/28/2014
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