Provider Demographics
NPI:1992718589
Name:CAPITOL ASSOCIATES, SC
Entity type:Organization
Organization Name:CAPITOL ASSOCIATES, SC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:JOHNA
Authorized Official - Middle Name:
Authorized Official - Last Name:GERASCH
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:608-238-5176
Mailing Address - Street 1:440 SCIENCE DR.,
Mailing Address - Street 2:STE 200
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53711
Mailing Address - Country:US
Mailing Address - Phone:608-238-5176
Mailing Address - Fax:608-238-2727
Practice Address - Street 1:440 SCIENCE DR.,
Practice Address - Street 2:STE 200
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53711
Practice Address - Country:US
Practice Address - Phone:608-238-5176
Practice Address - Fax:608-238-2727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-14
Last Update Date:2008-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI42163800Medicaid
WI42163800Medicaid