Provider Demographics
NPI:1699094912
Name:HEALTHY CONNECTIONS, LLC
Entity type:Organization
Organization Name:HEALTHY CONNECTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHROEDER
Authorized Official - Suffix:
Authorized Official - Credentials:PSY D
Authorized Official - Phone:920-257-4601
Mailing Address - Street 1:1000 W WISCONSIN AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54914-3551
Mailing Address - Country:US
Mailing Address - Phone:920-257-4601
Mailing Address - Fax:920-257-4603
Practice Address - Street 1:1000 W WISCONSIN AVE STE 1
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54914-3551
Practice Address - Country:US
Practice Address - Phone:920-257-4601
Practice Address - Fax:920-257-4603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-26
Last Update Date:2024-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2911261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100009466Medicaid
WIWI2100OtherMEDICARE PTAN