Provider Demographics
NPI:1215177373
Name:THE RAINBOW PROJECT, INC.
Entity type:Organization
Organization Name:THE RAINBOW PROJECT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, CHILD/FAMILY THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:SHARYL
Authorized Official - Middle Name:JEANNE
Authorized Official - Last Name:KATO
Authorized Official - Suffix:
Authorized Official - Credentials:MS LPC
Authorized Official - Phone:608-255-7356
Mailing Address - Street 1:831 E WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53703-2935
Mailing Address - Country:US
Mailing Address - Phone:608-255-7356
Mailing Address - Fax:608-255-0457
Practice Address - Street 1:831 E WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53703-2935
Practice Address - Country:US
Practice Address - Phone:608-255-7356
Practice Address - Fax:608-255-0457
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-03
Last Update Date:2009-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1944 125251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1944 125OtherLICENSED PROFESSIONAL COUNSELOR
WI88111930OtherANTHEM BLUE CROSS BLUE SHIELD