Provider Demographics
NPI:1992808364
Name:WAUSAU PSYCHIATRISTS SC
Entity type:Organization
Organization Name:WAUSAU PSYCHIATRISTS SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:A
Authorized Official - Last Name:GARVEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:715-845-1244
Mailing Address - Street 1:520 N 28TH AVENUE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WAUSAU
Mailing Address - State:WI
Mailing Address - Zip Code:54401
Mailing Address - Country:US
Mailing Address - Phone:715-845-1244
Mailing Address - Fax:715-848-0640
Practice Address - Street 1:520 N 28TH AVENUE
Practice Address - Street 2:SUITE 200
Practice Address - City:WAUSAU
Practice Address - State:WI
Practice Address - Zip Code:54401
Practice Address - Country:US
Practice Address - Phone:715-845-1244
Practice Address - Fax:715-848-0640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health