Provider Demographics
NPI:1982364204
Name:CATAPULT WELLNESS LLC
Entity type:Organization
Organization Name:CATAPULT WELLNESS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINICAL ADMINISTRATOR/CEO
Authorized Official - Prefix:
Authorized Official - First Name:ERIKA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:BROXTON
Authorized Official - Suffix:
Authorized Official - Credentials:APSW
Authorized Official - Phone:414-253-7494
Mailing Address - Street 1:3026 W CONCORDIA AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53216-3853
Mailing Address - Country:US
Mailing Address - Phone:414-253-7494
Mailing Address - Fax:414-296-0273
Practice Address - Street 1:3026 W CONCORDIA AVE STE 100
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53216-3853
Practice Address - Country:US
Practice Address - Phone:414-253-7494
Practice Address - Fax:414-296-0273
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-28
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No251B00000XAgenciesCase Management
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local