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Wraparound
Vendor List
16th Street Behavioral Health Center Maria Perez, Clinical Director
1032 S. 16 Street
Agency Director:Agency Phone: 414-672-1353
414-383-5597Agency FAX:
Service Code/Description Service Unit
Contact phone: 414-672-3145Brenda HughesProgram Contact, if any:Milwaukee, WI 53204
Rate
YesM.A. Eligible?
5000A Assessments-M.D. Session $200.00
5111A Individual/Family Therapy Lic. Psychologist-Office Session $100.00
5100 Individual/Family Therapy-Office Quarter Hour $16.00
5050 Psychiatric Review/Meds Session $80.00
5222A Treatment Plan Meeting Attendance Session $96.00
Acacia Mental Health Clinic, LLC Abe Freund
6040 W. Lisbon Avenue
Agency Director:Agency Phone: 414-871-9111
414-871-9121Agency FAX:
Suite 102
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Milwaukee, WI 53210
Rate
YesM.A. Eligible?
5111A Individual/Family Therapy Lic. Psychologist-Office Session $100.00
5222A Treatment Plan Meeting Attendance Session $96.00
Adkins Counseling Services, LLC Marcella Adkins
3723 N. 22 Street
Agency Director:Agency Phone: 414-393-1099
414-393-9773Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedJacqueline MarshallProgram Contact, if any:Milwaukee, WI 53206
Rate
YesM.A. Eligible?
5160 In-Home Lead Medicaid Hour $60.00
5100 Individual/Family Therapy-Office Quarter Hour $16.00
5222A Treatment Plan Meeting Attendance Session $96.00
AJA Counseling Center Bevelyn Johnson
8726 W. Mill Road
Agency Director:Agency Phone: 414-353-9250
414-353-2095Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Milwaukee, WI 53225
Rate
NoM.A. Eligible?
6001 Audit Recoveries Dollar $1.00
5500A Care Coordination-Daily Daily $26.50
5580 Discretionary Funds Total $1.00
5160 In-Home Lead Medicaid Hour $60.00
Alternatives In Psych. Consult. Pamela Fleider
10045 W. Lisbon Avenue
Agency Director:Agency Phone: 414-358-7999
414-393-1640Agency FAX:
Suite 200
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Wauwatosa, WI 53222
Rate
YesM.A. Eligible?
5500A Care Coordination-Daily Daily $26.50
5303 Crisis Stabilization/Supervision Hour $27.50
5303B Crisis Stabilization/Supervision-BA/BS/MS Hour $40.00
10/30/12 Page 1 of 38Printed:
Wraparound
Vendor List
Alternatives In Psych. Consult. Pamela Fleider
10045 W. Lisbon Avenue
Agency Director:Agency Phone: 414-358-7999
414-393-1640Agency FAX:
Suite 200
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Wauwatosa, WI 53222
Rate
YesM.A. Eligible?
5561 Daily Living Skills-Individual Hour $30.00
5580 Discretionary Funds Total $1.00
5590 House Mgmt Services Hour $23.00
5595 Housing Assistance Hour $25.00
5160 In-Home Lead Medicaid Hour $60.00
5111A Individual/Family Therapy Lic. Psychologist-Office Session $100.00
5100 Individual/Family Therapy-Office Quarter Hour $16.00
5563B Life Skills Training - Individual Hour $32.00
5524 Mentoring Hour $22.00
5522 Parent Assistance Hour $30.00
5510 Targeted Case Mgmt / SAIL Service Quarter Hour $12.00
5222A Treatment Plan Meeting Attendance Session $96.00
5521 Tutor Hour $22.00
American United Taxicab Service Richard Christensen, General Manager
646 South Second Street
Agency Director:Agency Phone: 414-220-5000
414-220-5017Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Milwaukee, WI 53204
Rate
NoM.A. Eligible?
5576A Taxi - American United Taxicab No Show Trip $5.00
5576 Taxi - American United Taxicab Service Dollar $1.00
AMRI Counseling Services, LLC LaKeia Jones
1915 N. Martin Luther King Drive
Agency Director:Agency Phone: 414-810-6691
866-719-3024Agency FAX:
Suite 213D Mailbox 54
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Milwauke, WI 53212
Rate
YesM.A. Eligible?
5001 AODA Assessment Quarter Hour $25.00
5121 AODA Group Counseling Quarter Hour $8.00
5101 AODA Individual/Family Counseling Quarter Hour $16.00
5103 AODA Lab and Medical Services Dollar $1.00
5120 Group Counseling and Therapy Quarter Hour $8.00
5160 In-Home Lead Medicaid Hour $60.00
5100 Individual/Family Therapy-Office Quarter Hour $16.00
5222A Treatment Plan Meeting Attendance Session $96.00
Angels Counseling & Therapy Service Augustina Garba
1401 N. Martin Luther King Drive
Agency Director:Agency Phone: 414-630-0102
414-455-8362Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Milwaukee, WI 53212
Rate
YesM.A. Eligible?
10/30/12 Page 2 of 38Printed:
Wraparound
Vendor List
Angels Counseling & Therapy Service Augustina Garba
1401 N. Martin Luther King Drive
Agency Director:Agency Phone: 414-630-0102
414-455-8362Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Milwaukee, WI 53212
Rate
YesM.A. Eligible?
5160 In-Home Lead Medicaid Hour $60.00
5100 Individual/Family Therapy-Office Quarter Hour $16.00
5222A Treatment Plan Meeting Attendance Session $96.00
Anu Family Services, Inc. Amelia Franck Meyer
516 Second Street
Agency Director:Agency Phone: 608-663-1262
608-663-1271Agency FAX:
Suite 209
Service Code/Description Service Unit
Contact phone: 414-431-2843Peggy GrimmerProgram Contact, if any:Hudson, WI 54016
Rate
NoM.A. Eligible?
5411 Respite, Foster care Daily $84.91
5311 Treat. Foster Care (Agency) Daily $63.50
Applied Therapies and Wellnes Center S.C. Lisa Hill
1033 N. Mayfair Road
Agency Director:Agency Phone: 414-302-1233
414-302-1234Agency FAX:
Suite 305
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Wauwatosa, WI 53226
Rate
YesM.A. Eligible?
5001 AODA Assessment Quarter Hour $25.00
5160 In-Home Lead Medicaid Hour $60.00
5100 Individual/Family Therapy-Office Quarter Hour $16.00
5180B Psychological Eval. Extended-Ph.D. Dollar $1.00
5180A Psychological Evaluation Services-Ph.D. Evaluation $350.00
5222A Treatment Plan Meeting Attendance Session $96.00
Associated Mental Health Consultants, Inc. Curt Ammel
2600 N. Mayfair Road
Agency Director:Agency Phone: 414-257-0233
414-257-3588Agency FAX:
Suite 305
Service Code/Description Service Unit
Contact phone: None listedBarbara PackerProgram Contact, if any:Wauwatosa, WI 53226
Rate
YesM.A. Eligible?
5160 In-Home Lead Medicaid Hour $60.00
5100 Individual/Family Therapy-Office Quarter Hour $16.00
5222A Treatment Plan Meeting Attendance Session $96.00
Aurora Family Service Jane Pirsig
3200 W. Highland Boulevard
Agency Director:Agency Phone: 414-342-4560
414-345-3161Agency FAX:
Service Code/Description Service Unit
Contact phone: 414-345-4442Alice FullerProgram Contact, if any:Milwaukee, WI 53208
Rate
NoM.A. Eligible?
5500A Care Coordination-Daily Daily $26.50
5580 Discretionary Funds Total $1.00
10/30/12 Page 3 of 38Printed:
Wraparound
Vendor List
Aurora Family Service Jane Pirsig
3200 W. Highland Boulevard
Agency Director:Agency Phone: 414-342-4560
414-345-3161Agency FAX:
Service Code/Description Service Unit
Contact phone: 414-345-4442Alice FullerProgram Contact, if any:Milwaukee, WI 53208
Rate
NoM.A. Eligible?
5100 Individual/Family Therapy-Office Quarter Hour $16.00
5222A Treatment Plan Meeting Attendance Session $96.00
Autism Intervention Milwaukee, LLC (AIM) Kathleen B. Woody, PsyD
2645 N. Mayfair Road
Agency Director:Agency Phone: 414-256-0077
414-256-0090Agency FAX:
Suite 130
Service Code/Description Service Unit
Contact phone: 414-256-0077Patti ObligatoProgram Contact, if any:Wauwatosa, WI 53226
Rate
YesM.A. Eligible?
5165 Home-Based Behavioral Mgm-Aide Hour $30.00
5163 Home-Based Behavioral Mgm-Lead Hour $70.00
5164 Home-Based Behavioral Mgm-Technician Hour $50.00
5221 Professional Consultation Hour $100.00
5180B Psychological Eval. Extended-Ph.D. Dollar $1.00
5180A Psychological Evaluation Services-Ph.D. Evaluation $350.00
Beasley, James, LCSW James Beasley, LCSW
8601 N. Servite Drive
Agency Director:Agency Phone: 414-305-8933
414-716-0158Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Milwaukee, WI 53223
Rate
NoM.A. Eligible?
5160 In-Home Lead Medicaid Hour $60.00
Benevolence First, Inc. Shirley Senaya
11020 W. Arch Ct.
Agency Director:Agency Phone: 414-461-8171
414-461-8130Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Milwaukee, WI 53224
Rate
YesM.A. Eligible?
5411 Respite, Foster care Daily $75.00
5311 Treat. Foster Care (Agency) Daily $60.67
Berman Group Home-Norris Don Harris
W247 S10395 Center Drive
Agency Director:Agency Phone: 262-662-5900
262-662-5688Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedWes JarrellProgram Contact, if any:Mukwonago, WI 53149
Rate
NoM.A. Eligible?
5400 Group Home Care Daily $192.10
Blessed Hope Agency Lynn Wagner
4477 Skylark Lane
Agency Director:Agency Phone: 414-915-5518
414-421-2008Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Greendale, WI 53129
Rate
NoM.A. Eligible?
10/30/12 Page 4 of 38Printed:
Wraparound
Vendor List
Blessed Hope Agency Lynn Wagner
4477 Skylark Lane
Agency Director:Agency Phone: 414-915-5518
414-421-2008Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Greendale, WI 53129
Rate
NoM.A. Eligible?
5561 Daily Living Skills-Individual Hour $30.00
5590 House Mgmt Services Hour $23.00
5595 Housing Assistance Hour $25.00
5522 Parent Assistance Hour $30.00
Bracy Psychological Service & Stress Mgm
Institut
Earl Bracy, Psy.D.
5225 N. Ironwood Road
Agency Director:Agency Phone: 414-963-1115
414-963-1169Agency FAX:
Suite 103
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Glendale, WI 53217
Rate
NoM.A. Eligible?
6001 Audit Recoveries Dollar $1.00
5160 In-Home Lead Medicaid Hour $60.00
5111A Individual/Family Therapy Lic. Psychologist-Office Session $100.00
5222A Treatment Plan Meeting Attendance Session $96.00
Bray Consultants James Bray, Ph.D.
16655 W. Bluemound Road
Agency Director:Agency Phone: 262-821-0588
262-821-0599Agency FAX:
Suite 300
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Brookfield, WI 53005
Rate
YesM.A. Eligible?
5111A Individual/Family Therapy Lic. Psychologist-Office Session $100.00
5222A Treatment Plan Meeting Attendance Session $96.00
Brooks, William, MSSW, LCSW William Brooks, MSSW, LCSW
5464 N. Port Washington Road
Agency Director:Agency Phone: 414-324-1920
414-265-7179Agency FAX:
C131
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Milwaukee, WI 53217
Rate
NoM.A. Eligible?
5160 In-Home Lead Medicaid Hour $60.00
Career Youth Development, Inc. (CYD) Charles Walton
2603 N. Martin Luther King Drive
Agency Director:Agency Phone: 414-263-8352
414-264-2264Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedSterlon R. WhiteProgram Contact, if any:Milwaukee, WI 53212
Rate
NoM.A. Eligible?
5001 AODA Assessment Quarter Hour $25.00
5121 AODA Group Counseling Quarter Hour $8.00
5101 AODA Individual/Family Counseling Quarter Hour $16.00
5103 AODA Lab and Medical Services Dollar $1.00
5222A Treatment Plan Meeting Attendance Session $96.00
10/30/12 Page 5 of 38Printed:
Wraparound
Vendor List
Carmelite Home, Inc. James Lewis
1214 Kavanaugh Place
Agency Director:Agency Phone: 414-258-4791
414-258-8464Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Wauwatosa, WI 53213
Rate
NoM.A. Eligible?
5340 Residential Care Center for Children & Youth Daily $318.18
Caroline Palmer, M.D., S.C. Caroline Palmer, M.D.
2600 N. Mayfair Road
Agency Director:Agency Phone: 414-939-9596
888-328-0777Agency FAX:
Suite 850
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Wauwatosa, WI 53226
Rate
YesM.A. Eligible?
5000A Assessments-M.D. Session $200.00
5051 Psychiatric Review/Meds-with Therapy Session $150.00
5222A Treatment Plan Meeting Attendance Session $96.00
Center for Communication, Hearing and
Deafness
Dorothy Kerr
10243 W. National Ave.
Agency Director:Agency Phone: 414-604-7203
414-604-7200Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedLaurel KuppermanProgram Contact, if any:West Allis, WI 53227
Rate
YesM.A. Eligible?
5600 Interpreters Hour $58.00
Center for Family Preservation, Inc. (The) Arthur Kennedy
7315 N. Teutonia Avenue
Agency Director:Agency Phone: 414-540-9750
414-540-9750Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Milwaukee, WI 53209
Rate
NoM.A. Eligible?
5521 Tutor Hour $22.00
Changes Group Home-LSS Dennis Behn
PO Box 88732
Agency Director:Agency Phone: 920-982-6670
920-982-6677Agency FAX:
Service Code/Description Service Unit
Contact phone: 715-341-7301Michael ThielProgram Contact, if any:Milwaukee, WI 53288-0732
Rate
NoM.A. Eligible?
5400 Group Home Care Daily $192.10
Children's Hospital of Wisconsin Tracy Oerter, Clinic Manager
P.O. Box 1997 MS958
Agency Director:Agency Phone: 414-266-2932
414-266-3735Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Milwaukee, WI 53201-1997
Rate
YesM.A. Eligible?
5000A Assessments-M.D. Session $200.00
5120 Group Counseling and Therapy Quarter Hour $8.00
5113B Health and Behavior Consultation, Ongoing Session $100.00
5113A Health and Behavior Initial Assessment Session $100.00
5111A Individual/Family Therapy Lic. Psychologist-Office Session $100.00
10/30/12 Page 6 of 38Printed:
Wraparound
Vendor List
Children's Hospital of Wisconsin Tracy Oerter, Clinic Manager
P.O. Box 1997 MS958
Agency Director:Agency Phone: 414-266-2932
414-266-3735Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Milwaukee, WI 53201-1997
Rate
YesM.A. Eligible?
5100 Individual/Family Therapy-Office Quarter Hour $16.00
5050 Psychiatric Review/Meds Session $80.00
5051 Psychiatric Review/Meds-with Therapy Session $150.00
5180B Psychological Eval. Extended-Ph.D. Dollar $1.00
5180A Psychological Evaluation Services-Ph.D. Evaluation $350.00
5222A Treatment Plan Meeting Attendance Session $96.00
Children's Service Society of WI Bob Duncan
Fair Park Business Center
Agency Director:Agency Phone: 414-453-1400
414-453-2538Agency FAX:
620 S. 76 Street, Suite 120
Service Code/Description Service Unit
Contact phone: 414-453-1400Amy HerbstProgram Contact, if any:Milwaukee, WI 53214
Rate
YesM.A. Eligible?
5580 Discretionary Funds Total $1.00
5111A Individual/Family Therapy Lic. Psychologist-Office Session $100.00
5100 Individual/Family Therapy-Office Quarter Hour $16.00
5411 Respite, Foster care Daily $75.00
5311 Treat. Foster Care (Agency) Daily $63.50
5311A Treat. Foster Care (Agency) Youth w/Dependent Daily $128.98
Childynamics, LLC Isabela Sardas, PhD
11904 W. North Avenue
Agency Director:Agency Phone: 414-258-4318
414-258-4328Agency FAX:
Suite 110
Service Code/Description Service Unit
Contact phone: None listedJane SchroederProgram Contact, if any:Wauwatosa, WI 53226
Rate
NoM.A. Eligible?
5172 Day Treatment (Medicaid-day) Daily $112.00
Chileda Institute, Inc. Ruth Wiseman
1825 Victory Street
Agency Director:Agency Phone: 608-782-6480
608-782-6481Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedLynn KayProgram Contact, if any:La Crosse, WI 54601
Rate
YesM.A. Eligible?
5340 Residential Care Center for Children & Youth Daily $437.16
Choices Group Home for Girls-LSS Dennis Behn
P.O. Box 88732
Agency Director:Agency Phone: 715-341-7301
715-341-7580Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedMichael ThielProgram Contact, if any:Milwaukee, WI 53288-0732
Rate
NoM.A. Eligible?
5400 Group Home Care Daily $192.10
10/30/12 Page 7 of 38Printed:
Wraparound
Vendor List
Christian Life Counseling Eric Seybold
12690 W. North Avenue
Agency Director:Agency Phone: 262-785-1008
262-785-0644Agency FAX:
Building C
Service Code/Description Service Unit
Contact phone: 262-785-1008Amanda RiskeProgram Contact, if any:Brookfield, WI 53005
Rate
NoM.A. Eligible?
5111A Individual/Family Therapy Lic. Psychologist-Office Session $100.00
5100 Individual/Family Therapy-Office Quarter Hour $16.00
Community Care Resources, Inc. Daniel J. Simon
6717 Stone Glen Drive
Agency Director:Agency Phone: 608-827-7100
608-827-7101Agency FAX:
Service Code/Description Service Unit
Contact phone: 608-827-7100Brian SullivanProgram Contact, if any:Middleton, WI 53562-3876
Rate
NoM.A. Eligible?
5311 Treat. Foster Care (Agency) Daily $63.50
Connecting Youth Group Home Sharon Riley
P.O. Box 170347
Agency Director:Agency Phone: 414-466-3628
414-461-1330Agency FAX:
Service Code/Description Service Unit
Contact phone: 414-466-3628Willie HopgoodProgram Contact, if any:Milwaukee, WI 53217-8031
Rate
NoM.A. Eligible?
5302 Crisis Bed-Group Home Daily $192.10
5400 Group Home Care Daily $192.10
5403 Group Home Crisis Supervision Hour $70.00
Connecting Youth II Sharon Riley
P.O. Box 170347
Agency Director:Agency Phone: 414-466-3628
414-461-1330Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedWillie HopgoodProgram Contact, if any:Milwaukee, WI 53217-8031
Rate
NoM.A. Eligible?
5302 Crisis Bed-Group Home Daily $192.10
5400 Group Home Care Daily $192.10
Cornerstone Counseling Services John Wirkus
16535 West Bluemound Road
Agency Director:Agency Phone: 262-789-1191
262-821-6180Agency FAX:
Suite 200
Service Code/Description Service Unit
Contact phone: None listedLinda SlabyProgram Contact, if any:Brookfield, WI 53005
Rate
YesM.A. Eligible?
5001 AODA Assessment Quarter Hour $25.00
5121 AODA Group Counseling Quarter Hour $8.00
5101 AODA Individual/Family Counseling Quarter Hour $16.00
5103 AODA Lab and Medical Services Dollar $1.00
5222A Treatment Plan Meeting Attendance Session $96.00
Cornerstone Youth & Family Service Jonathan Hilson
PO Box 170615
Agency Director:Agency Phone: 414-228-8478
414-228-4638Agency FAX:
10/30/12 Page 8 of 38Printed:
Wraparound
Vendor List
Cornerstone Youth & Family Service Jonathan Hilson
PO Box 170615
Agency Director:Agency Phone: 414-228-8478
414-228-4638Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Milwaukee, WI 53217
Rate
NoM.A. Eligible?
5557A Employment Preparation and Placement-Phase One Total $400.00
5557C Employment Preparation and Placement-Phase Three Total $700.00
5557B Employment Preparation and Placement-Phase Two Total $700.00
Crossroads To Independence GH-St. Rose Debbie Zwicky
P.O. Box 158
Agency Director:Agency Phone: 414-466-3009
414-760-8097Agency FAX:
Service Code/Description Service Unit
Contact phone: 414-760-8073Jessica WaldronProgram Contact, if any:Dousman, WI 53118
Rate
NoM.A. Eligible?
5302 Crisis Bed-Group Home Daily $192.10
5400 Group Home Care Daily $192.10
Current Initiatives Counseling Service, LLC LaShawnda Davis
6815 W. Capitol Drive
Agency Director:Agency Phone: 414-616-8805
414-616-2296Agency FAX:
Suite 311
Service Code/Description Service Unit
Contact phone: 414-586-9377Phyllis McClartyProgram Contact, if any:Milwaukee, WI 53216
Rate
YesM.A. Eligible?
5565B Anger Management Group Quarter Hour $7.50
5001 AODA Assessment Quarter Hour $25.00
5101 AODA Individual/Family Counseling Quarter Hour $16.00
5103 AODA Lab and Medical Services Dollar $1.00
5160 In-Home Lead Medicaid Hour $60.00
5100 Individual/Family Therapy-Office Quarter Hour $16.00
5222A Treatment Plan Meeting Attendance Session $96.00
Cynthia A. Noffsinger, LLC Cynthia A. Noffsinger
13500 W. Capitol Drive
Agency Director:Agency Phone: 262-781-1976
414-937-5190Agency FAX:
Suite 104
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Brookfield, WI 53005
Rate
YesM.A. Eligible?
5160 In-Home Lead Medicaid Hour $60.00
5100 Individual/Family Therapy-Office Quarter Hour $16.00
5222A Treatment Plan Meeting Attendance Session $96.00
DCS Transport Services, LLC James Morgan
8400 W. Silver Spring Drive
Agency Director:Agency Phone: 414-461-8622
414-461-8624Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Milwaukee, WI 53225
Rate
NoM.A. Eligible?
5577 Transportation Trip $15.00
5578 Transportation Mileage Miles $1.75
10/30/12 Page 9 of 38Printed:
Wraparound
Vendor List
DCS Transport Services, LLC James Morgan
8400 W. Silver Spring Drive
Agency Director:Agency Phone: 414-461-8622
414-461-8624Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Milwaukee, WI 53225
Rate
NoM.A. Eligible?
5579 Transportation-Additional Passenger Each $10.00
Discovery & Recovery Clinic, Inc. Wade Koski
4402 South 68th Street
Agency Director:Agency Phone: 414-321-4411
414-321-0552Agency FAX:
#100
Service Code/Description Service Unit
Contact phone: 414-321-4411Kristy WittProgram Contact, if any:Greenfield, WI 53220
Rate
YesM.A. Eligible?
5160 In-Home Lead Medicaid Hour $60.00
5100 Individual/Family Therapy-Office Quarter Hour $16.00
5222A Treatment Plan Meeting Attendance Session $96.00
Dominion Behavioral Health Services, LLC Francine Dixon
W132 N6303 Marach Road
Agency Director:Agency Phone: 262-751-7507
262-252-7567Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Menomonee Falls, WI 53051
Rate
NoM.A. Eligible?
5160 In-Home Lead Medicaid Hour $60.00
Eagles Nest Group Home-LSS Dennis Behn
PO Box 88732
Agency Director:Agency Phone: 715-238-7323
715-238-7755Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedMichael ThielProgram Contact, if any:Milwaukee, WI 5388-0732
Rate
NoM.A. Eligible?
5400 Group Home Care Daily $192.10
Easter Seals Southeast Wisconsin Bob Glowacki, CEO
1016 Milwaukee Avenue
Agency Director:Agency Phone: 414-571-5566
414-571-5568Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedBeth CausierProgram Contact, if any:South Milwaukee, WI 53172
Rate
NoM.A. Eligible?
5202 After School Programs Hour $12.00
5522 Parent Assistance Hour $30.00
5527 Recreation Programming-Half Day Daily $61.95
Eau Claire Academy Charles Albrent
550 N. Dewey Street
Agency Director:Agency Phone: 715-834-6681
715-834-9954Agency FAX:
P.O. Box 1168
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Eau Claire, WI 54702-1168
Rate
NoM.A. Eligible?
5340 Residential Care Center for Children & Youth Daily $316.03
5345 Residential Care-Specialized Daily $318.18
10/30/12 Page 10 of 38Printed:
Wraparound
Vendor List
Eau Claire Academy Charles Albrent
550 N. Dewey Street
Agency Director:Agency Phone: 715-834-6681
715-834-9954Agency FAX:
P.O. Box 1168
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Eau Claire, WI 54702-1168
Rate
NoM.A. Eligible?
5412 Respite, Residential Daily $154.52
Emiley, Stephen, Ph.D. Dr. Stephen F. Emiley
5800 N. Bayshore Drive
Agency Director:Agency Phone: 414-961-0030
262-375-3368Agency FAX:
Suite A-230
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Glendale, WI 53217
Rate
NoM.A. Eligible?
5180B Psychological Eval. Extended-Ph.D. Dollar $1.00
5180A Psychological Evaluation Services-Ph.D. Evaluation $350.00
Empowerment Clinic, Inc. Cathy Bear, Executive Director
6001 W. Center Street
Agency Director:Agency Phone: 414-763-1757
414-449-4850Agency FAX:
Suite 100
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Milwaukee, WI 53210
Rate
YesM.A. Eligible?
5001 AODA Assessment Quarter Hour $25.00
5121 AODA Group Counseling Quarter Hour $8.00
5101 AODA Individual/Family Counseling Quarter Hour $16.00
5103 AODA Lab and Medical Services Dollar $1.00
5160 In-Home Lead Medicaid Hour $60.00
5100 Individual/Family Therapy-Office Quarter Hour $16.00
5222A Treatment Plan Meeting Attendance Session $96.00
Ertl, Richard J. Ph.D. Richard J. Ertl, Ph.D.
2266 N. Prospect Avenue
Agency Director:Agency Phone: 414-226-0137
414-226-0137Agency FAX:
Suite 510
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Milwaukee, WI 53202
Rate
YesM.A. Eligible?
5111A Individual/Family Therapy Lic. Psychologist-Office Session $100.00
5180B Psychological Eval. Extended-Ph.D. Dollar $1.00
5180A Psychological Evaluation Services-Ph.D. Evaluation $350.00
Eulopia Family Services, Inc. Marica Tipton
2125 Derrin Lane
Agency Director:Agency Phone: 414-297-7745
262-641-9768Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Brookfield, WI 53045
Rate
YesM.A. Eligible?
5160 In-Home Lead Medicaid Hour $60.00
5521 Tutor Hour $22.00
10/30/12 Page 11 of 38Printed:
Wraparound
Vendor List
Exodus Family Services, LLC Alexander Hardy
2556 N. Sherman Blvd.
Agency Director:Agency Phone: 414-550-9646
414-445-7858Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Milwaukee, WI 53210
Rate
YesM.A. Eligible?
5160 In-Home Lead Medicaid Hour $60.00
5100 Individual/Family Therapy-Office Quarter Hour $16.00
5222A Treatment Plan Meeting Attendance Session $96.00
Express Yourself Milwaukee, Inc. Lori Vance
3331 W. Lisbon Avenue
Agency Director:Agency Phone: 414-272-3498
414-501-2364Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Milwaukee, WI 53208
Rate
NoM.A. Eligible?
5201 Camp Total $35.00
5130 Special Therapy Quarter Hour $16.00
5131 Special Therapy-Group Quarter Hour $8.00
5222A Treatment Plan Meeting Attendance Session $96.00
Family Crisis Counseling Doreen A. Foyer
P.O. Box 242
Agency Director:Agency Phone: 262-679-1003
262-679-1004Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Hales Corners, WI 53130
Rate
NoM.A. Eligible?
5160 In-Home Lead Medicaid Hour $60.00
Family Options Counseling, LLC Christina Diorio
3015 N. 114th St.
Agency Director:Agency Phone: 414-431-4444
414-431-0858Agency FAX:
Service Code/Description Service Unit
Contact phone: 414-431-4444Julie YangProgram Contact, if any:Wauwatosa, WI 53222
Rate
NoM.A. Eligible?
5565B Anger Management Group Quarter Hour $7.50
5120 Group Counseling and Therapy Quarter Hour $8.00
5111A Individual/Family Therapy Lic. Psychologist-Office Session $100.00
5100 Individual/Family Therapy-Office Quarter Hour $16.00
5180B Psychological Eval. Extended-Ph.D. Dollar $1.00
5180A Psychological Evaluation Services-Ph.D. Evaluation $350.00
5222A Treatment Plan Meeting Attendance Session $96.00
5704 Youth Relationship Building-A.S.A.P. Session $37.50
Family Works Programs, Inc. Rachel Karow / Valerie Smith (co-directors)
5604 Medical Circle
Agency Director:Agency Phone: 608-233-9204
608-233-9710Agency FAX:
Service Code/Description Service Unit
Contact phone: 608-233-9204Lyn UngrodtProgram Contact, if any:Madison, WI 53719-1204
Rate
NoM.A. Eligible?
5411 Respite, Foster care Daily $90.00
5311 Treat. Foster Care (Agency) Daily $60.82
10/30/12 Page 12 of 38Printed:
Wraparound
Vendor List
Fannie Wells Group Home-Norris Adolescent
Ctr
Don Harris
W247 S10395 Center Drive
Agency Director:Agency Phone: 262-662-5900
262-662-5688Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedWes JarrellProgram Contact, if any:Mukwonago, WI 53149
Rate
NoM.A. Eligible?
5302 Crisis Bed-Group Home Daily $192.10
5400 Group Home Care Daily $192.10
Fokus Family Services, LLC Elzora Collins
2821 N. 4 Street
Agency Director:Agency Phone: 414-264-4217
414-264-4218Agency FAX:
Suite 139
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Milwaukee, WI 53212
Rate
NoM.A. Eligible?
6001 Audit Recoveries Dollar $1.00
5100 Individual/Family Therapy-Office Quarter Hour $16.00
5522 Parent Assistance Hour $30.00
Forward Choices, LLC Michael L. Wallner
140 N. Hine Avenue
Agency Director:Agency Phone: 414-442-1751
414-442-1775Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Waukesha, WI 53188
Rate
YesM.A. Eligible?
5100 Individual/Family Therapy-Office Quarter Hour $16.00
5222A Treatment Plan Meeting Attendance Session $96.00
Foster Care Youth Independence Ctr. of WI,
Inc.
James A. Pekrul
2433 N. Holton Street
Agency Director:Agency Phone: 414-264-6290
414-264-6073Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedKyna Campbell-JordonProgram Contact, if any:Milwaukee, WI 53212
Rate
NoM.A. Eligible?
5557A Employment Preparation and Placement-Phase One Total $400.00
5557C Employment Preparation and Placement-Phase Three Total $700.00
5557B Employment Preparation and Placement-Phase Two Total $700.00
5563B Life Skills Training - Individual Hour $32.00
Fresh Start Counseling Center Jermaine Reed
1720 W. Florist Avenue
Agency Director:Agency Phone: 414-351-1100
414-431-0831Agency FAX:
Suite 200
Service Code/Description Service Unit
Contact phone: None listedShaun RobeyProgram Contact, if any:Glendale, WI 53209
Rate
NoM.A. Eligible?
5580 Discretionary Funds Total $1.00
5389 Foster Home Maintenance Hour $60.00
5590 House Mgmt Services Hour $23.00
5595 Housing Assistance Hour $25.00
5411 Respite, Foster care Daily $50.00
5410 Respite, Hourly Hour $10.00
10/30/12 Page 13 of 38Printed:
Wraparound
Vendor List
Fresh Start Counseling Center Jermaine Reed
1720 W. Florist Avenue
Agency Director:Agency Phone: 414-351-1100
414-431-0831Agency FAX:
Suite 200
Service Code/Description Service Unit
Contact phone: None listedShaun RobeyProgram Contact, if any:Glendale, WI 53209
Rate
NoM.A. Eligible?
5311 Treat. Foster Care (Agency) Daily $63.50
5504 Treat. Foster Care-Care Coordination Daily $198.00
5504B Treatment Foster Care Case Management Daily $24.50
Greensquare Developmental Specialists Tracy Clemens, Office Manager
PO Box 78841
Agency Director:Agency Phone: 414-228-4800
414-247-0894Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Milwaukee, WI 53278
Rate
NoM.A. Eligible?
5100 Individual/Family Therapy-Office Quarter Hour $16.00
5222A Treatment Plan Meeting Attendance Session $96.00
GRO Family Services Gregory Owens
2011 W. Capitol Drive
Agency Director:Agency Phone: 414-445-1400
414-395-4716Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Milwaukee, WI 53206
Rate
YesM.A. Eligible?
5001 AODA Assessment Quarter Hour $25.00
5121 AODA Group Counseling Quarter Hour $8.00
5101 AODA Individual/Family Counseling Quarter Hour $16.00
5103 AODA Lab and Medical Services Dollar $1.00
5160 In-Home Lead Medicaid Hour $60.00
5100 Individual/Family Therapy-Office Quarter Hour $16.00
5222A Treatment Plan Meeting Attendance Session $96.00
Hale-Richlen Center for Psychiatry (The) Barbara Hale-Richlen, M.D.
2600 N. Mayfair Road
Agency Director:Agency Phone: 414-771-7700
414-771-6308Agency FAX:
Suite 850 - North Tower
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Wauwatosa, WI 53226
Rate
NoM.A. Eligible?
5000A Assessments-M.D. Session $200.00
5051 Psychiatric Review/Meds-with Therapy Session $150.00
5222A Treatment Plan Meeting Attendance Session $96.00
Harmony Social Services CPA, Inc. Jocelyn Hall
7431 W. Bradley Road
Agency Director:Agency Phone: 414-354-9830
414-354-9845Agency FAX:
Service Code/Description Service Unit
Contact phone: 414-354-9830Jay WarnerProgram Contact, if any:Milwaukee, WI 53223
Rate
NoM.A. Eligible?
5202 After School Programs Hour $12.00
5526 Recreation Programming-Full Day Daily $55.00
10/30/12 Page 14 of 38Printed:
Wraparound
Vendor List
Harmony Social Services CPA, Inc. Jocelyn Hall
7431 W. Bradley Road
Agency Director:Agency Phone: 414-354-9830
414-354-9845Agency FAX:
Service Code/Description Service Unit
Contact phone: 414-354-9830Jay WarnerProgram Contact, if any:Milwaukee, WI 53223
Rate
NoM.A. Eligible?
5411 Respite, Foster care Daily $75.00
5311 Treat. Foster Care (Agency) Daily $63.50
Harper House-NEHEMIAH PROJECT Marye Beth Dugan
2574 North Cramer Street
Agency Director:Agency Phone: 414-961-7016
414-961-0757Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedMaryE Beth DuganProgram Contact, if any:Milwaukee, WI 53211
Rate
NoM.A. Eligible?
5302 Crisis Bed-Group Home Daily $173.86
5400 Group Home Care Daily $173.86
Homme Home Youth & Family Programs -
LSS
Ronald A. Hauser, Vice President
P.O. Box 88732
Agency Director:Agency Phone: 715-253-2116
715-253-3586Agency FAX:
Service Code/Description Service Unit
Contact phone: 715-253-2116Margie MechProgram Contact, if any:Milwaukee, WI 53288-0732
Rate
NoM.A. Eligible?
5340 Residential Care Center for Children & Youth Daily $318.00
5345 Residential Care-Specialized Daily $318.00
5346 Residential Care-Type II Daily $318.00
Hopgood Youth Home Willie Hopgood
P.O. Box 241572
Agency Director:Agency Phone: 414-444-8690
414-444-8691Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Milwaukee, WI 53224
Rate
NoM.A. Eligible?
5302 Crisis Bed-Group Home Daily $192.10
5400 Group Home Care Daily $192.10
5403 Group Home Crisis Supervision Hour $70.00
Horizon Healthcare, Inc. Darren Matakva, Executive VP
285 N. Janacek Road
Agency Director:Agency Phone: 262-641-9050
262-641-9126Agency FAX:
Service Code/Description Service Unit
Contact phone: 262-641-9050Nicki BauerProgram Contact, if any:Brookfield, WI 53045-6102
Rate
YesM.A. Eligible?
5001 AODA Assessment Quarter Hour $25.00
5101 AODA Individual/Family Counseling Quarter Hour $16.00
5100 Individual/Family Therapy-Office Quarter Hour $16.00
House of Jabez, LLC Cynthia Simpson
P.O. BOX 16966
Agency Director:Agency Phone: 414-213-5730
414-462-3294Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Milwaukee, WI 53216
Rate
NoM.A. Eligible?
10/30/12 Page 15 of 38Printed:
Wraparound
Vendor List
House of Jabez, LLC Cynthia Simpson
P.O. BOX 16966
Agency Director:Agency Phone: 414-213-5730
414-462-3294Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Milwaukee, WI 53216
Rate
NoM.A. Eligible?
5577 Transportation Trip $15.00
5578 Transportation Mileage Miles $1.75
5579 Transportation-Additional Passenger Each $10.00
House of Love II Julette Francis-Wade
P.O. Box 240066
Agency Director:Agency Phone: 414-446-4077
414-446-4145Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Milwaukee, WI 53224
Rate
NoM.A. Eligible?
5302 Crisis Bed-Group Home Daily $192.10
5403 Group Home Crisis Supervision Hour $70.00
5402 Group Home-Specialized Daily $192.10
House of Love Youth Homes, Inc. Julette Francis-Wade
P.O. Box 240066
Agency Director:Agency Phone: 414-446-4077
414-446-4145Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Milwaukee, WI 53224
Rate
NoM.A. Eligible?
5302 Crisis Bed-Group Home Daily $192.10
5400 Group Home Care Daily $192.10
5403 Group Home Crisis Supervision Hour $70.00
Human Development Center, Inc. Chuck Holloway, Ph.D.
P.O. Box 274
Agency Director:Agency Phone: 414-449-9908
414-449-9912Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Milwaukee, WI 53201-0274
Rate
NoM.A. Eligible?
6001 Audit Recoveries Dollar $1.00
5303 Crisis Stabilization/Supervision Hour $27.50
5303B Crisis Stabilization/Supervision-BA/BS/MS Hour $40.00
5160 In-Home Lead Medicaid Hour $60.00
5524 Mentoring Hour $22.00
Hyssop Diagnostic Treatment and Social
Service Ag.
Ericka Rush
8960 N. Santa Monica Blvd.
Agency Director:Agency Phone: 414-397-2222
414-540-9926Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Bayside, WI 53217
Rate
YesM.A. Eligible?
5160 In-Home Lead Medicaid Hour $60.00
5100 Individual/Family Therapy-Office Quarter Hour $16.00
5222A Treatment Plan Meeting Attendance Session $96.00
10/30/12 Page 16 of 38Printed:
Wraparound
Vendor List
ICF Consultants, Inc. Marilyn J. Bonjean
1524 N. Farwell Avenue
Agency Director:Agency Phone: 414-273-2220
414-273-2223Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Milwaukee, WI 53202
Rate
NoM.A. Eligible?
5100 Individual/Family Therapy-Office Quarter Hour $16.00
Integrative Solutions, LLC Kathleen Frank
13500 W. Capitol Drive
Agency Director:Agency Phone: 262-781-1996
262-781-1997Agency FAX:
Suite 104
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Brookfield, WI 53005-2444
Rate
YesM.A. Eligible?
5160 In-Home Lead Medicaid Hour $60.00
5100 Individual/Family Therapy-Office Quarter Hour $16.00
5222A Treatment Plan Meeting Attendance Session $96.00
Integrity Family Services, LLC Raymond Arredondo
P.O. Box 70237
Agency Director:Agency Phone: 414-483-8671
414-483-8672Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Milwaukee, WI 53207-0237
Rate
NoM.A. Eligible?
5202 After School Programs Hour $12.00
5565B Anger Management Group Quarter Hour $7.50
5551 BRICK Program Session $55.00
5303 Crisis Stabilization/Supervision Hour $27.50
5303B Crisis Stabilization/Supervision-BA/BS/MS Hour $40.00
5524 Mentoring Hour $22.00
5550A Parent Correctional Facility Visit. Trip $250.00
5550B Parent Correctional Facility Visit.-Escort Trip $10.00
5270 School Accountability Program Daily $55.00
Jackson, Denis Ian, Ph.D. Denis Ian Jackson, Ph.D.
11931 W. Bluemound Road
Agency Director:Agency Phone: 414-276-8669
414-276-1266Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Wauwatosa, WI 53226
Rate
YesM.A. Eligible?
5180B Psychological Eval. Extended-Ph.D. Dollar $1.00
5180A Psychological Evaluation Services-Ph.D. Evaluation $350.00
Jewish Family Services, Inc. Sylvan Leabman
1300 N. Jackson Street
Agency Director:Agency Phone: 414-390-5800
414-390-5808Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Milwaukee, WI 53202
Rate
YesM.A. Eligible?
5100 Individual/Family Therapy-Office Quarter Hour $16.00
5222A Treatment Plan Meeting Attendance Session $96.00
10/30/12 Page 17 of 38Printed:
Wraparound
Vendor List
JW Transportation, LLC Johnny Walker
4523 West Medford Avenue
Agency Director:Agency Phone: 414-445-3373
414-873-3299Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Milwaukee, WI 53216
Rate
NoM.A. Eligible?
5577 Transportation Trip $15.00
5578 Transportation Mileage Miles $1.75
5579 Transportation-Additional Passenger Each $10.00
La Causa, Inc. Chyra Trost
P.O. Box 04188
Agency Director:Agency Phone: 414-902-1500
414-771-7674Agency FAX:
Service Code/Description Service Unit
Contact phone: 414-902-1551Chyra TrostProgram Contact, if any:Milwaukee, WI 53204-0188
Rate
YesM.A. Eligible?
5001 AODA Assessment Quarter Hour $25.00
5121 AODA Group Counseling Quarter Hour $8.00
5101 AODA Individual/Family Counseling Quarter Hour $16.00
5103 AODA Lab and Medical Services Dollar $1.00
6001 Audit Recoveries Dollar $1.00
5500A Care Coordination-Daily Daily $26.50
5440 Child Care (Daily) Daily $45.00
5441 Child Care (Hourly) Hour $6.00
5300 Crisis Bed-Foster Home Daily $60.00
5414 Crisis Respite and Nursery Daily $105.00
5303 Crisis Stabilization/Supervision Hour $27.50
5303B Crisis Stabilization/Supervision-BA/BS/MS Hour $40.00
5580 Discretionary Funds Total $1.00
5390 Foster Home Care Daily $18.77
5389 Foster Home Maintenance Hour $50.00
5120 Group Counseling and Therapy Quarter Hour $8.00
5160 In-Home Lead Medicaid Hour $60.00
5100 Individual/Family Therapy-Office Quarter Hour $16.00
5524 Mentoring Hour $22.00
5522 Parent Assistance Hour $30.00
5411 Respite, Foster care Daily $50.00
5410 Respite, Hourly Hour $10.00
5311 Treat. Foster Care (Agency) Daily $54.00
5311A Treat. Foster Care (Agency) Youth w/Dependent Daily $54.00
5504 Treat. Foster Care-Care Coordination Daily $198.00
5504A Treat. Foster Care-Care Coordination-Addt'l Youth Daily $120.00
5222A Treatment Plan Meeting Attendance Session $96.00
Lad Lake, Inc. Gary Erdmann
P.O. Box 158
Agency Director:Agency Phone: 414-342-0607
262-965-4107Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Dousman, WI 53118
Rate
NoM.A. Eligible?
10/30/12 Page 18 of 38Printed:
Wraparound
Vendor List
Lad Lake, Inc. Gary Erdmann
P.O. Box 158
Agency Director:Agency Phone: 414-342-0607
262-965-4107Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Dousman, WI 53118
Rate
NoM.A. Eligible?
5170 Day Treatment Daily $0.00
5580 Discretionary Funds Total $1.00
5563B Life Skills Training - Individual Hour $32.00
5340 Residential Care Center for Children & Youth Daily $318.18
5412 Respite, Residential Daily $137.07
5564A Supported Indep Living-Phase I Daily $99.00
5564B Supported Indep Living-Youth w/Dependent Daily $89.00
5564 Supported Independent Living Daily $77.00
5506 Transitional Specialist-Care Coordination Daily $18.50
Language Source LLC Elizabeth Bruderle-Baran
10425 W. North Avenue
Agency Director:Agency Phone: 414-607-8766
414-607-8767Agency FAX:
Suite 322
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Wauwatosa, WI 53226
Rate
NoM.A. Eligible?
5600 Interpreters Hour $45.00
Lawson's Transportation, LLC J.D. Lawson, Jr.
8922 W. Hope Avenue
Agency Director:Agency Phone: 414-763-7737
414-897-8309Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Milwaukee, WI 53222
Rate
YesM.A. Eligible?
5577 Transportation Trip $15.00
5578 Transportation Mileage Miles $1.75
5579 Transportation-Additional Passenger Each $10.00
Lissy's Place - My Home Your Home Constance Palmer-Jones
6200 W. Center Street
Agency Director:Agency Phone: 414-874-2560
414-874-2565Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Milwaukee, WI 53210
Rate
NoM.A. Eligible?
5564A Supported Indep Living-Phase I Daily $120.00
LS Transportation, Inc. Ellis Hooker
3767 N. 56 Street
Agency Director:Agency Phone: 414-429-1303
414-444-4427Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Milwaukee, WI 53216
Rate
YesM.A. Eligible?
5577 Transportation Trip $15.00
5578 Transportation Mileage Miles $1.75
5579 Transportation-Additional Passenger Each $10.00
10/30/12 Page 19 of 38Printed:
Wraparound
Vendor List
Lutheran Counseling & Family Services of WI Chuck Meseck, Psy.D.
3800 N. Mayfair Road
Agency Director:Agency Phone: 414-536-8333
414-536-8348Agency FAX:
Service Code/Description Service Unit
Contact phone: 414-536-8333Lisa HuebnerProgram Contact, if any:Wauwatosa, WI 53222
Rate
YesM.A. Eligible?
5001 AODA Assessment Quarter Hour $25.00
5121 AODA Group Counseling Quarter Hour $8.00
5101 AODA Individual/Family Counseling Quarter Hour $16.00
5100 Individual/Family Therapy-Office Quarter Hour $16.00
5222A Treatment Plan Meeting Attendance Session $96.00
Mary Determan MSW, LLC Mary Determan
5757 W. Oklahoma Avenue
Agency Director:Agency Phone: 414-431-6400
414-431-6401Agency FAX:
Suite 203
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Milwaukee, WI 53219
Rate
YesM.A. Eligible?
5100 Individual/Family Therapy-Office Quarter Hour $16.00
5222A Treatment Plan Meeting Attendance Session $96.00
MD Therapy Thomas Michael Dale
P.O. Box 11444
Agency Director:Agency Phone: 414-466-3204
414-466-3206Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Shorewood, WI 53211
Rate
YesM.A. Eligible?
5001 AODA Assessment Quarter Hour $25.00
5101 AODA Individual/Family Counseling Quarter Hour $16.00
5160 In-Home Lead Medicaid Hour $60.00
5100 Individual/Family Therapy-Office Quarter Hour $16.00
5222A Treatment Plan Meeting Attendance Session $96.00
Med Group Transportation, LLC Dariko Mekvabishvili
11402 N. Port Washington Road
Agency Director:Agency Phone: 414-755-0500
414-755-1763Agency FAX:
Suite 215
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Mequon, WI 53092
Rate
YesM.A. Eligible?
5577 Transportation Trip $15.00
5578 Transportation Mileage Miles $1.75
5579 Transportation-Additional Passenger Each $10.00
Milwaukee Academy/Clinicare Dana K. Dorn, LCSW
C/o Child & Adolescent Treatment Center
Agency Director:Agency Phone: 414-257-3141
414-257-3151Agency FAX:
9501 Watertown Plank Road
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Wauwatosa, WI 53226
Rate
NoM.A. Eligible?
5340 Residential Care Center for Children & Youth Daily $318.18
10/30/12 Page 20 of 38Printed:
Wraparound
Vendor List
Milwaukee Academy/Clinicare Dana K. Dorn, LCSW
C/o Child & Adolescent Treatment Center
Agency Director:Agency Phone: 414-257-3141
414-257-3151Agency FAX:
9501 Watertown Plank Road
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Wauwatosa, WI 53226
Rate
NoM.A. Eligible?
5412 Respite, Residential Daily $139.20
Milwaukee Center For Independence Howard Garber
2020 W. Wells Street
Agency Director:Agency Phone: 414-937-2064
414-937-2021Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Milwaukee, WI 53233
Rate
NoM.A. Eligible?
5561 Daily Living Skills-Individual Hour $30.00
5522 Parent Assistance Hour $30.00
Milwaukee Christian Center Barbara Wyatt Sibley
2137 W. Greenfield Avenue
Agency Director:Agency Phone: 414-645-1974
414-645-1993Agency FAX:
Service Code/Description Service Unit
Contact phone: 414-645-5350Curtis WoodsProgram Contact, if any:Milwaukee, WI 53204
Rate
NoM.A. Eligible?
5521 Tutor Hour $22.00
MindStar Counseling, LLC Starlette Patterson
P.O. Box 16824
Agency Director:Agency Phone: 414-435-1115
414-435-0543Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Milwaukee, WI 53216-0824
Rate
YesM.A. Eligible?
5120 Group Counseling and Therapy Quarter Hour $8.00
5160 In-Home Lead Medicaid Hour $60.00
5100 Individual/Family Therapy-Office Quarter Hour $16.00
5222A Treatment Plan Meeting Attendance Session $96.00
Mt. Castle Transitional Living Services Scott Wilder
3808 W. Elm Street
Agency Director:Agency Phone: 414-540-6479
414-540-6993Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Milwaukee, WI 53209
Rate
NoM.A. Eligible?
5564C Supported Indep Living-Youth and Parent Daily $175.00
5564 Supported Independent Living Daily $75.00
My Home, Your Home Constance Palmer-Jones
6200 W. Center Street
Agency Director:Agency Phone: 414-874-2560
414-874-2565Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Milwaukee, WI 53210
Rate
NoM.A. Eligible?
6001 Audit Recoveries Dollar $1.00
5500A Care Coordination-Daily Daily $26.50
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Vendor List
My Home, Your Home Constance Palmer-Jones
6200 W. Center Street
Agency Director:Agency Phone: 414-874-2560
414-874-2565Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Milwaukee, WI 53210
Rate
NoM.A. Eligible?
5580 Discretionary Funds Total $1.00
5524 Mentoring Hour $22.00
5411 Respite, Foster care Daily $50.00
5311 Treat. Foster Care (Agency) Daily $51.05
Nakoda Cognitive Behavioral Services, LLC Geri McFadden
204 E. Capitol Drive
Agency Director:Agency Phone: 414-332-0886
414-332-0886Agency FAX:
Suite 106
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Milwaukee, WI 53212
Rate
NoM.A. Eligible?
5160 In-Home Lead Medicaid Hour $60.00
5100 Individual/Family Therapy-Office Quarter Hour $16.00
5222A Treatment Plan Meeting Attendance Session $96.00
Nervig, Mary Mary Nervig
8112 West Bluemound Road
Agency Director:Agency Phone: 414-258-5523
414-431-1071Agency FAX:
Suite 106
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Wauwatosa, WI 53213
Rate
NoM.A. Eligible?
5132 High Risk Counseling and Therapy Quarter Hour $20.00
5222A Treatment Plan Meeting Attendance Session $96.00
Neu-Life Community Resource Center Joann Comodore
2014 W. North Avenue
Agency Director:Agency Phone: 414-933-3924
414-933-3932Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Milwaukee, WI 53205
Rate
NoM.A. Eligible?
5202 After School Programs Hour $12.00
5562 Daily Living Skills-Group Hour $15.00
5563C Life Skills Training - Group Hour $16.00
5563B Life Skills Training - Individual Hour $32.00
5521 Tutor Hour $22.00
New C.H.O.I.C.E.S, LLC Leola Williams
3565 N. Martin Luther King Drive
Agency Director:Agency Phone: 414-444-8445
414-444-8432Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Milwaukee, WI 53212
Rate
YesM.A. Eligible?
5001 AODA Assessment Quarter Hour $25.00
5121 AODA Group Counseling Quarter Hour $8.00
5101 AODA Individual/Family Counseling Quarter Hour $16.00
10/30/12 Page 22 of 38Printed:
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New C.H.O.I.C.E.S, LLC Leola Williams
3565 N. Martin Luther King Drive
Agency Director:Agency Phone: 414-444-8445
414-444-8432Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Milwaukee, WI 53212
Rate
YesM.A. Eligible?
5222A Treatment Plan Meeting Attendance Session $96.00
New Concept Self Dev. Ctr/CSS Vanessa Johnson
1531 W. Vliet Street
Agency Director:Agency Phone: 414-344-5788
414-344-0423Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Milwaukee, WI 53205
Rate
NoM.A. Eligible?
5565B Anger Management Group Quarter Hour $7.50
5166 Female Family Systems Intervention Hour $35.00
New Horizon Center Crisis/Mentoring
Services, LLC
Hope Jackson
P.O. Box 18560
Agency Director:Agency Phone: 414-962-2300
414-962-3590Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Milwaukee, WI 53218
Rate
NoM.A. Eligible?
5303 Crisis Stabilization/Supervision Hour $27.50
5303B Crisis Stabilization/Supervision-BA/BS/MS Hour $40.00
5524 Mentoring Hour $22.00
New Horizon Center, Inc. Saleem El-Amin
4650 N. Port Washington Road
Agency Director:Agency Phone: 414-962-4000
414-962-4003Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Milwaukee, WI 53212
Rate
NoM.A. Eligible?
6001 Audit Recoveries Dollar $1.00
5411 Respite, Foster care Daily $60.00
5311 Treat. Foster Care (Agency) Daily $63.50
New Leaf Therapies, LLC Lynn Delahan
4465 N. Oakland Avenue
Agency Director:Agency Phone: 414-332-2227
414-332-2228Agency FAX:
Suite 400D
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Shorewood, WI 53211
Rate
YesM.A. Eligible?
5160 In-Home Lead Medicaid Hour $60.00
5100 Individual/Family Therapy-Office Quarter Hour $16.00
5222A Treatment Plan Meeting Attendance Session $96.00
Noah House Group Home-Sey&fs Edward Konkol (Interim)
8008 W. Capitol Drive
Agency Director:Agency Phone: 414-464-1800
414-464-1804Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedDenise BatesProgram Contact, if any:Milwaukee, WI 53222
Rate
NoM.A. Eligible?
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Noah House Group Home-Sey&fs Edward Konkol (Interim)
8008 W. Capitol Drive
Agency Director:Agency Phone: 414-464-1800
414-464-1804Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedDenise BatesProgram Contact, if any:Milwaukee, WI 53222
Rate
NoM.A. Eligible?
5302 Crisis Bed-Group Home Daily $192.10
5400 Group Home Care Daily $192.10
5403 Group Home Crisis Supervision Hour $70.00
Norris Adolescent Center Don Harris
W247 S10395 Center Drive
Agency Director:Agency Phone: 262-662-5900
262-662-5688Agency FAX:
Service Code/Description Service Unit
Contact phone: 262-662-5900Wes JerrellProgram Contact, if any:Mukwonago, WI 53149
Rate
NoM.A. Eligible?
5000A Assessments-M.D. Session $200.00
5100 Individual/Family Therapy-Office Quarter Hour $16.00
5050 Psychiatric Review/Meds Session $80.00
5340 Residential Care Center for Children & Youth Daily $305.83
5412 Respite, Residential Daily $196.00
North Shore Psychotherapy Associates Sheryl Dolezal, Psy.D. / Daniela Jaramillo, Psy.D.
5800 N. Bayshore Drive
Agency Director:Agency Phone: 414-962-6764
414-962-6765Agency FAX:
Suite A250
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Glendale, WI 53217-4516
Rate
YesM.A. Eligible?
5111A Individual/Family Therapy Lic. Psychologist-Office Session $100.00
5100 Individual/Family Therapy-Office Quarter Hour $16.00
5180B Psychological Eval. Extended-Ph.D. Dollar $1.00
5180A Psychological Evaluation Services-Ph.D. Evaluation $350.00
5222A Treatment Plan Meeting Attendance Session $96.00
Oconomowoc Developmental Training Ctr. of
WI LLC
Kim Ray
36100 Genesee Lake Road
Agency Director:Agency Phone: 262-569-5515
262-569-5513Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedStephanie Koster-PetersonProgram Contact, if any:Oconomowoc, WI 53066
Rate
NoM.A. Eligible?
5163 Home-Based Behavioral Mgm-Lead Hour $80.00
5164 Home-Based Behavioral Mgm-Technician Hour $60.00
5340 Residential Care Center for Children & Youth Daily $339.84
5410 Respite, Hourly Hour $18.00
5412 Respite, Residential Daily $170.00
Omni Enrichment, Inc. Barbara Tripp
P.O. Box 080272
Agency Director:Agency Phone: 414-312-8910
414-455-3292Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Milwaukee, WI 53208
Rate
YesM.A. Eligible?
10/30/12 Page 24 of 38Printed:
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Vendor List
Omni Enrichment, Inc. Barbara Tripp
P.O. Box 080272
Agency Director:Agency Phone: 414-312-8910
414-455-3292Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Milwaukee, WI 53208
Rate
YesM.A. Eligible?
5001 AODA Assessment Quarter Hour $25.00
5101 AODA Individual/Family Counseling Quarter Hour $16.00
5160 In-Home Lead Medicaid Hour $60.00
5222A Treatment Plan Meeting Attendance Session $96.00
Park West Social & Psychotherapy Services Clorine Henderson-Harris
2704 N. 87 Street
Agency Director:Agency Phone: 414-719-0434
414-771-0227Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Milwaukee, WI 53222
Rate
YesM.A. Eligible?
5160 In-Home Lead Medicaid Hour $60.00
5222A Treatment Plan Meeting Attendance Session $96.00
Pathfinders Milwaukee, Inc. Daniel Magnuson
4200 N. Holton Street
Agency Director:Agency Phone: 414-964-2565
414-964-0102Agency FAX:
Suite 400
Service Code/Description Service Unit
Contact phone: 414-271-2565Maryann ClesceriProgram Contact, if any:Milwaukee, WI 53212
Rate
YesM.A. Eligible?
5580 Discretionary Funds Total $1.00
5100 Individual/Family Therapy-Office Quarter Hour $16.00
5506 Transitional Specialist-Care Coordination Daily $18.50
5222A Treatment Plan Meeting Attendance Session $96.00
Pathways Counseling Center Sally S. Tarvid
13105 W. Bluemound Road
Agency Director:Agency Phone: 262-641-9790
262-641-9791Agency FAX:
Suite 100
Service Code/Description Service Unit
Contact phone: 262-641-9790Susan GoebelProgram Contact, if any:Brookfield, WI 53005-8046
Rate
YesM.A. Eligible?
5132 High Risk Counseling and Therapy Quarter Hour $20.00
5160 In-Home Lead Medicaid Hour $60.00
5100 Individual/Family Therapy-Office Quarter Hour $16.00
5222A Treatment Plan Meeting Attendance Session $96.00
Peace Home Robert Harmon
3042 Coolidge Avenue
Agency Director:Agency Phone: 262-632-4330
262-632-4336Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Racine, WI 53403
Rate
NoM.A. Eligible?
5302 Crisis Bed-Group Home Daily $192.10
5400 Group Home Care Daily $192.10
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Pediatric Associates (Samir Mullick MD, S.C.) Samir Mullick, M.D.
P.O. Box 933
Agency Director:Agency Phone: 414-873-3440
414-873-3440Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Hales Corners, WI 53130
Rate
YesM.A. Eligible?
5111A Individual/Family Therapy Lic. Psychologist-Office Session $100.00
5180B Psychological Eval. Extended-Ph.D. Dollar $1.00
5180A Psychological Evaluation Services-Ph.D. Evaluation $350.00
5222A Treatment Plan Meeting Attendance Session $96.00
Pediatric Psychology Associates Mary Gustafson, Psy.D
3636 N. 124 Street
Agency Director:Agency Phone: 414-476-9755
414-476-3413Agency FAX:
Suite 200
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Milwaukee, WI 53222-2125
Rate
NoM.A. Eligible?
5111A Individual/Family Therapy Lic. Psychologist-Office Session $100.00
5222A Treatment Plan Meeting Attendance Session $96.00
Positive Outlook Clinical Services Pamela Hansen
8421 N. 102 Court
Agency Director:Agency Phone: 414-460-6995
414-355-5467Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Milwaukee, WI 53224
Rate
YesM.A. Eligible?
5160 In-Home Lead Medicaid Hour $60.00
5100 Individual/Family Therapy-Office Quarter Hour $16.00
5222A Treatment Plan Meeting Attendance Session $96.00
Professional Services Group, Inc. David Houghton, President
1126 S. 70 Street
Agency Director:Agency Phone: 414-475-2788
414-476-8695Agency FAX:
Suite S-507
Service Code/Description Service Unit
Contact phone: 414-727-2790Paul MoellerProgram Contact, if any:West Allis, WI 53214
Rate
YesM.A. Eligible?
5001 AODA Assessment Quarter Hour $25.00
5101 AODA Individual/Family Counseling Quarter Hour $16.00
5103 AODA Lab and Medical Services Dollar $1.00
5000A Assessments-M.D. Session $200.00
5160 In-Home Lead Medicaid Hour $60.00
5100 Individual/Family Therapy-Office Quarter Hour $16.00
5050 Psychiatric Review/Meds Session $80.00
5180B Psychological Eval. Extended-Ph.D. Dollar $1.00
5180A Psychological Evaluation Services-Ph.D. Evaluation $350.00
5222A Treatment Plan Meeting Attendance Session $96.00
Project Excel-CCC (WCS)
1300 S. Layton Boulevard
Agency Director:Agency Phone:
Agency FAX:
10/30/12 Page 26 of 38Printed:
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Project Excel-CCC (WCS)
1300 S. Layton Boulevard
Agency Director:Agency Phone:
Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Milwaukee, WI 53204
Rate
NoM.A. Eligible?
5170 Day Treatment Daily $0.00
PsyCare-Milwaukee LLC Thomas A. Garland, Psy.D.
633 W. Wisconsin Avenue
Agency Director:Agency Phone: 414-271-3322
414-271-2335Agency FAX:
Suite 1810
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Milwaukee, WI 53203
Rate
YesM.A. Eligible?
5100 Individual/Family Therapy-Office Quarter Hour $16.00
5222A Treatment Plan Meeting Attendance Session $96.00
Rangel Tapia, Maria Del Carmen Maria Del Carmen Rangel Tapia
1629 W. Becher Street
Agency Director:Agency Phone: 414-467-7191
Agency FAX:
Upper
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Milwaukee, WI 53215
Rate
NoM.A. Eligible?
5160 In-Home Lead Medicaid Hour $60.00
Rawhide, Inc. John Solberg
E7475 Rawhide Road
Agency Director:Agency Phone: 920-982-6100
920-982-5040Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedDanny StoneProgram Contact, if any:New London, WI 54961-9052
Rate
NoM.A. Eligible?
5390 Foster Home Care Daily $63.50
5100 Individual/Family Therapy-Office Quarter Hour $16.00
5340 Residential Care Center for Children & Youth Daily $294.00
5222A Treatment Plan Meeting Attendance Session $96.00
REACH, Inc. Comprehensive Mental Health
Clinic
Roger Pumphrey
6310 N. Port Washington Road
Agency Director:Agency Phone: 414-961-1600
414-961-1616Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Glendale, WI 53217
Rate
YesM.A. Eligible?
5001 AODA Assessment Quarter Hour $25.00
5101 AODA Individual/Family Counseling Quarter Hour $16.00
5100 Individual/Family Therapy-Office Quarter Hour $16.00
Renew Counseling Services Wayne Croatt
1225 W. Mitchell St.
Agency Director:Agency Phone: 414-383-4455
414-433-0171Agency FAX:
Suite 223
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Renew Counseling Services Wayne Croatt
1225 W. Mitchell St.
Agency Director:Agency Phone: 414-383-4455
414-433-0171Agency FAX:
Suite 223
Service Code/Description Service Unit
Contact phone: 414-383-4455Bruce CroattProgram Contact, if any:Milwaukee, WI 53204
Rate
YesM.A. Eligible?
5001 AODA Assessment Quarter Hour $25.00
5101 AODA Individual/Family Counseling Quarter Hour $16.00
5103 AODA Lab and Medical Services Dollar $1.00
5160 In-Home Lead Medicaid Hour $60.00
5100 Individual/Family Therapy-Office Quarter Hour $16.00
5050 Psychiatric Review/Meds Session $80.00
5222A Treatment Plan Meeting Attendance Session $96.00
Right Turn II Shawn Broomfield
1102 W. Arthur Ave.
Agency Director:Agency Phone: 414-759-6092
414-672-8626Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Milwaukee, WI 53215
Rate
NoM.A. Eligible?
5302 Crisis Bed-Group Home Daily $192.10
5400 Group Home Care Daily $192.10
5403 Group Home Crisis Supervision Hour $70.00
Right Turn, Inc. Shawn Broomfield
1102 W. Arthur Ave.
Agency Director:Agency Phone: 414-672-8345
414-672-8626Agency FAX:
Service Code/Description Service Unit
Contact phone: 414-759-6092Shawn BroomfieldProgram Contact, if any:Milwaukee, WI 53215
Rate
NoM.A. Eligible?
5302 Crisis Bed-Group Home Daily $192.10
5400 Group Home Care Daily $192.10
5403 Group Home Crisis Supervision Hour $70.00
Right Way Development Center Mona Williams
2949 N. Martin Luther King Drive
Agency Director:Agency Phone: 414-265-5940
414-265-5941Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Milwaukee, WI 53212
Rate
NoM.A. Eligible?
5202 After School Programs Hour $12.00
5561 Daily Living Skills-Individual Hour $30.00
5595 Housing Assistance Hour $25.00
5410 Respite, Hourly Hour $10.00
Roads to Independence Group Home Cathy Connolly
4757 N. 76 Street
Agency Director:Agency Phone: 414-476-3710
414-778-5985Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Milwaukee, WI 53218
Rate
NoM.A. Eligible?
5302 Crisis Bed-Group Home Daily $0.00
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Roads to Independence Group Home Cathy Connolly
4757 N. 76 Street
Agency Director:Agency Phone: 414-476-3710
414-778-5985Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Milwaukee, WI 53218
Rate
NoM.A. Eligible?
5400 Group Home Care Daily $0.00
Running Rebels Community Organization Victor Barnett
1300A W. Fond Du Lac Avenue
Agency Director:Agency Phone: 414-264-8222
414-264-8233Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedAmanda J. O'DayProgram Contact, if any:Milwaukee, WI 53205
Rate
NoM.A. Eligible?
5202 After School Programs Hour $12.00
6001 Audit Recoveries Dollar $1.00
5303 Crisis Stabilization/Supervision Hour $24.50
5303B Crisis Stabilization/Supervision-BA/BS/MS Hour $37.00
5557A Employment Preparation and Placement-Phase One Total $400.00
5557C Employment Preparation and Placement-Phase Three Total $700.00
5557B Employment Preparation and Placement-Phase Two Total $700.00
5524 Mentoring Hour $22.00
5526 Recreation Programming-Full Day Daily $60.00
5527 Recreation Programming-Half Day Daily $45.00
5410 Respite, Hourly Hour $10.00
5577 Transportation Trip $15.00
5578 Transportation Mileage Miles $1.75
5579 Transportation-Additional Passenger Each $10.00
Schroeder Group Home-Norris Don Harris
W247 S10395 Center Drive
Agency Director:Agency Phone: 262-662-5900
262-662-5688Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedWes JarrellProgram Contact, if any:Mukwonago, WI 53149
Rate
NoM.A. Eligible?
5400 Group Home Care Daily $192.10
Sebastian Family Psychology Practice Sebastian Ssempijja, Ph.D
1720 W. Florist Avenue
Agency Director:Agency Phone: 414-247-0801
414-247-0816Agency FAX:
Suite 125
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Glendale, WI 53209
Rate
YesM.A. Eligible?
5001 AODA Assessment Quarter Hour $25.00
5101 AODA Individual/Family Counseling Quarter Hour $16.00
5000A Assessments-M.D. Session $200.00
5161 In-Home Case Aide Hour $30.00
5160 In-Home Lead Medicaid Hour $60.00
5111A Individual/Family Therapy Lic. Psychologist-Office Session $100.00
5100 Individual/Family Therapy-Office Quarter Hour $16.00
5600 Interpreters Hour $30.00
10/30/12 Page 29 of 38Printed:
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Vendor List
Sebastian Family Psychology Practice Sebastian Ssempijja, Ph.D
1720 W. Florist Avenue
Agency Director:Agency Phone: 414-247-0801
414-247-0816Agency FAX:
Suite 125
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Glendale, WI 53209
Rate
YesM.A. Eligible?
5522 Parent Assistance Hour $30.00
5051 Psychiatric Review/Meds-with Therapy Session $150.00
5180B Psychological Eval. Extended-Ph.D. Dollar $1.00
5180A Psychological Evaluation Services-Ph.D. Evaluation $350.00
5222A Treatment Plan Meeting Attendance Session $96.00
Servant Manor Group Home I Adrienne Hunter
P.O. Box 091484
Agency Director:Agency Phone: 414-358-3527
414-371-2448Agency FAX:
Service Code/Description Service Unit
Contact phone: 414-257-7353Cheryl PetersonProgram Contact, if any:Milwaukee, WI 53209
Rate
NoM.A. Eligible?
5302 Crisis Bed-Group Home Daily $192.10
5400 Group Home Care Daily $192.10
5403 Group Home Crisis Supervision Hour $70.00
Servant Manor, Inc. Adrienne Hunter
P.O. Box 091484
Agency Director:Agency Phone: 414-371-2427
414-371-2448Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Milwaukee, WI 53209
Rate
NoM.A. Eligible?
5563B Life Skills Training - Individual Hour $32.00
5564A Supported Indep Living-Phase I Daily $115.00
Shecar Substance Abuse/Mental Health OP Tx
Center
Sheila Ramos
2821 N. 4 Street
Agency Director:Agency Phone: 414-372-3903
414-372-3964Agency FAX:
Suite 308
Service Code/Description Service Unit
Contact phone: 414-372-3903Sheila RamosProgram Contact, if any:Milwaukee, WI 53212
Rate
YesM.A. Eligible?
5001 AODA Assessment Quarter Hour $25.00
5101 AODA Individual/Family Counseling Quarter Hour $16.00
5103 AODA Lab and Medical Services Dollar $1.00
5160 In-Home Lead Medicaid Hour $60.00
5100 Individual/Family Therapy-Office Quarter Hour $16.00
5222A Treatment Plan Meeting Attendance Session $96.00
5521 Tutor Hour $22.00
Shorehaven Behavioral Health, Inc. Don Rosenberg
3900 West Brown Deer Road
Agency Director:Agency Phone: 414-540-2170
414-540-2171Agency FAX:
Suite 200
10/30/12 Page 30 of 38Printed:
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Vendor List
Shorehaven Behavioral Health, Inc. Don Rosenberg
3900 West Brown Deer Road
Agency Director:Agency Phone: 414-540-2170
414-540-2171Agency FAX:
Suite 200
Service Code/Description Service Unit
Contact phone: 414-540-2170Lynn GodecProgram Contact, if any:Brown Deer, WI 53209
Rate
YesM.A. Eligible?
5001 AODA Assessment Quarter Hour $25.00
5101 AODA Individual/Family Counseling Quarter Hour $16.00
5103 AODA Lab and Medical Services Dollar $1.00
5000A Assessments-M.D. Session $200.00
5161 In-Home Case Aide Hour $30.00
5160 In-Home Lead Medicaid Hour $60.00
5100 Individual/Family Therapy-Office Quarter Hour $16.00
5050 Psychiatric Review/Meds Session $80.00
5222A Treatment Plan Meeting Attendance Session $96.00
Sierra Group Home-LSS Steven Dunn
N3987 Highway 55
Agency Director:Agency Phone: 715-882-4821
715-882-5005Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:White Lake, WI 54491
Rate
NoM.A. Eligible?
5400 Group Home Care Daily $175.00
Social Development Commission Deborah Blanks
4041 N. Richards Street
Agency Director:Agency Phone: 414-906-2700
414-963-2691Agency FAX:
Service Code/Description Service Unit
Contact phone: 414-906-2710Jan StenlundProgram Contact, if any:Milwaukee, WI 53212
Rate
NoM.A. Eligible?
5001 AODA Assessment Quarter Hour $25.00
5101 AODA Individual/Family Counseling Quarter Hour $16.00
5701 Family Connections Groups Hour $35.00
5100 Individual/Family Therapy-Office Quarter Hour $16.00
5222A Treatment Plan Meeting Attendance Session $96.00
Southeastern Youth & Family Services, Inc. Edward Konkol (Interim)
8008 W. Capitol Drive
Agency Director:Agency Phone: 414-464-1800
414-464-1804Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedDenise BatesProgram Contact, if any:Milwaukee, WI 53222
Rate
NoM.A. Eligible?
5521 Tutor Hour $22.00
Southwest Key Programs, Inc. Juan J. Sanchez
6002 Jain Lain
Agency Director:Agency Phone: 414-543-1079
414-543-1097Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedJudy TramonteProgram Contact, if any:Austin, TX 78721
Rate
NoM.A. Eligible?
5303 Crisis Stabilization/Supervision Hour $27.50
5303B Crisis Stabilization/Supervision-BA/BS/MS Hour $40.00
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Vendor List
Southwest Key Programs, Inc. Juan J. Sanchez
6002 Jain Lain
Agency Director:Agency Phone: 414-543-1079
414-543-1097Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedJudy TramonteProgram Contact, if any:Austin, TX 78721
Rate
NoM.A. Eligible?
5524 Mentoring Hour $22.00
Spahn Clinical Services LeAnn Spahn
3010 E. Forest Lane
Agency Director:Agency Phone: 414-416-8259
414-571-6140Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Oak Creek, WI 53154
Rate
YesM.A. Eligible?
5160 In-Home Lead Medicaid Hour $60.00
St. Aemilian - Lakeside Teri Zywicki
8901 W. Capitol Drive
Agency Director:Agency Phone: 414-463-1880
414-463-2770Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedMichael BoederProgram Contact, if any:Milwaukee, WI 53222-1798
Rate
NoM.A. Eligible?
5500A Care Coordination-Daily Daily $26.50
5174 Day Treatment Specialized (Non-Medicaid) Daily $168.00
5580 Discretionary Funds Total $1.00
5313 Placement Stabilization Center Daily $184.00
5340 Residential Care Center for Children & Youth Daily $318.18
5411 Respite, Foster care Daily $70.00
5410 Respite, Hourly Hour $10.00
5412 Respite, Residential Daily $152.00
5311 Treat. Foster Care (Agency) Daily $63.50
5504 Treat. Foster Care-Care Coordination Daily $198.00
5222A Treatment Plan Meeting Attendance Session $96.00
St. Catherine Residence Lynne Oehlke
1032 E. Knapp Street
Agency Director:Agency Phone: 414-272-8470
414-272-7579Agency FAX:
Service Code/Description Service Unit
Contact phone: 414-272-8470Kae BuelowProgram Contact, if any:Milwaukee, WI 53202
Rate
NoM.A. Eligible?
5564 Supported Independent Living Daily $60.00
St. Charles Youth and Family Serv. Cathy Connolly
4757 N. 76 Street
Agency Director:Agency Phone: 414-358-4173
414-358-5005Agency FAX:
Service Code/Description Service Unit
Contact phone: 414-358-4152Glynis UnderwoodProgram Contact, if any:Milwaukee, WI 53218
Rate
YesM.A. Eligible?
5001 AODA Assessment Quarter Hour $25.00
5121 AODA Group Counseling Quarter Hour $8.00
5101 AODA Individual/Family Counseling Quarter Hour $16.00
5103 AODA Lab and Medical Services Dollar $1.00
5000A Assessments-M.D. Session $200.00
10/30/12 Page 32 of 38Printed:
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Vendor List
St. Charles Youth and Family Serv. Cathy Connolly
4757 N. 76 Street
Agency Director:Agency Phone: 414-358-4173
414-358-5005Agency FAX:
Service Code/Description Service Unit
Contact phone: 414-358-4152Glynis UnderwoodProgram Contact, if any:Milwaukee, WI 53218
Rate
YesM.A. Eligible?
5500A Care Coordination-Daily Daily $26.50
5303 Crisis Stabilization/Supervision Hour $27.50
5303B Crisis Stabilization/Supervision-BA/BS/MS Hour $40.00
5170 Day Treatment Daily $0.00
5172 Day Treatment (Medicaid-day) Daily $112.00
5580 Discretionary Funds Total $1.00
5557A Employment Preparation and Placement-Phase One Total $400.00
5557C Employment Preparation and Placement-Phase Three Total $700.00
5557B Employment Preparation and Placement-Phase Two Total $700.00
5160 In-Home Lead Medicaid Hour $60.00
5100 Individual/Family Therapy-Office Quarter Hour $16.00
5591 On The Job Training Total $1,000.00
5522 Parent Assistance Hour $30.00
5050 Psychiatric Review/Meds Session $80.00
5051 Psychiatric Review/Meds-with Therapy Session $150.00
5340 Residential Care Center for Children & Youth Daily $240.00
5411 Respite, Foster care Daily $50.00
5415 Respite-Crisis-FOCUS Daily $211.00
5311 Treat. Foster Care (Agency) Daily $61.26
5504 Treat. Foster Care-Care Coordination Daily $198.00
5504A Treat. Foster Care-Care Coordination-Addt'l Youth Daily $120.00
5222A Treatment Plan Meeting Attendance Session $96.00
St. Rose Youth & Family Center, Inc. Debbie Zwicky
P.O. Box 158
Agency Director:Agency Phone: 414-760-8082
414-466-0730Agency FAX:
Service Code/Description Service Unit
Contact phone: 414-466-9450Debbie ZwickyProgram Contact, if any:Dousman, WI 53118
Rate
YesM.A. Eligible?
5202 After School Programs Hour $12.00
5001 AODA Assessment Quarter Hour $25.00
5121 AODA Group Counseling Quarter Hour $8.00
5101 AODA Individual/Family Counseling Quarter Hour $16.00
5103 AODA Lab and Medical Services Dollar $1.00
5000A Assessments-M.D. Session $200.00
5160 In-Home Lead Medicaid Hour $60.00
5100 Individual/Family Therapy-Office Quarter Hour $16.00
5550A Parent Correctional Facility Visit. Trip $275.00
5550C Parent Correctional Facility Visit.-Orientation Session $70.00
5050 Psychiatric Review/Meds Session $80.00
5051 Psychiatric Review/Meds-with Therapy Session $150.00
5340 Residential Care Center for Children & Youth Daily $318.18
5412 Respite, Residential Daily $135.00
10/30/12 Page 33 of 38Printed:
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Vendor List
St. Rose Youth & Family Center, Inc. Debbie Zwicky
P.O. Box 158
Agency Director:Agency Phone: 414-760-8082
414-466-0730Agency FAX:
Service Code/Description Service Unit
Contact phone: 414-466-9450Debbie ZwickyProgram Contact, if any:Dousman, WI 53118
Rate
YesM.A. Eligible?
5222A Treatment Plan Meeting Attendance Session $96.00
STAGES - St. Rose Debbie Zwicky
P.O. Box 158
Agency Director:Agency Phone: 414-466-0783
414-466-0730Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Dousman, WI 53118
Rate
NoM.A. Eligible?
5313 Placement Stabilization Center Daily $184.00
Star 1 Limousine, LLC Hazel Johnson
3939 W. Concordia Avenue
Agency Director:Agency Phone: 414-444-7800
414-444-7880Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Milwaukee, WI 53216
Rate
NoM.A. Eligible?
5577 Transportation Trip $15.00
5578 Transportation Mileage Miles $1.75
5579 Transportation-Additional Passenger Each $10.00
T & H Group Home - Mt. Castle Corp. Robb Taylor
3808 W. Elm Street
Agency Director:Agency Phone: 414-263-2337
414-540-6993Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Milwaukee, WI 53209
Rate
NoM.A. Eligible?
5302 Crisis Bed-Group Home Daily $188.16
5400 Group Home Care Daily $188.16
Teen Living Center II-AJA Enterprises Bevelyn Johnson
8726 W. Mill Road
Agency Director:Agency Phone: 414-760-1950
414-353-2095Agency FAX:
Service Code/Description Service Unit
Contact phone: 414-760-1950Valerie NashProgram Contact, if any:Milwaukee, WI 53225
Rate
NoM.A. Eligible?
5302 Crisis Bed-Group Home Daily $190.45
5400 Group Home Care Daily $190.45
5403 Group Home Crisis Supervision Hour $70.00
Terry-Len Transportation Lenda St. Claire-Gibson
5517 N. 91 Street
Agency Director:Agency Phone: 414-444-2444
414-444-3666Agency FAX:
#1
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Milwaukee, WI 53225
Rate
NoM.A. Eligible?
5577 Transportation Trip $15.00
5578 Transportation Mileage Miles $1.75
10/30/12 Page 34 of 38Printed:
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Vendor List
Terry-Len Transportation Lenda St. Claire-Gibson
5517 N. 91 Street
Agency Director:Agency Phone: 414-444-2444
414-444-3666Agency FAX:
#1
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Milwaukee, WI 53225
Rate
NoM.A. Eligible?
5579 Transportation-Additional Passenger Each $10.00
The Bridge Health Clinics & Research Centers,
Inc.
Todd Campbell
600 W. Virginia Street
Agency Director:Agency Phone: 414-831-4500
414-255-3451Agency FAX:
Atlas Building, Suite 203
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Milwaukee, WI 53204
Rate
YesM.A. Eligible?
5101 AODA Individual/Family Counseling Quarter Hour $16.00
5100 Individual/Family Therapy-Office Quarter Hour $16.00
5222A Treatment Plan Meeting Attendance Session $96.00
The Richardson School, LLC Kevin Silkey
6753 W. Rogers Street
Agency Director:Agency Phone: 414-540-8500
414-541-8500Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:West Allis, WI 53219
Rate
NoM.A. Eligible?
5568 Specialized Academic Support Service Hour $55.00
5521 Tutor Hour $22.00
Therapies East Associates Joan Felski
827 N. Cass Street
Agency Director:Agency Phone: 414-278-7980
414-278-8299Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Milwaukee, WI 53202
Rate
NoM.A. Eligible?
5100 Individual/Family Therapy-Office Quarter Hour $16.00
5222A Treatment Plan Meeting Attendance Session $96.00
THRIVE Treatment Services, LLC Jenna Daniels
507 Margaret Street
Agency Director:Agency Phone: 920-206-9888
920-206-3797Agency FAX:
Suite A
Service Code/Description Service Unit
Contact phone: 414-640-0482Lakenya KirkendollProgram Contact, if any:Watertown, WI 53098
Rate
NoM.A. Eligible?
5411 Respite, Foster care Daily $50.00
5311 Treat. Foster Care (Agency) Daily $63.50
Tomorrow's Future, LLC Lynell V. Monnie
P.O. Box 18324
Agency Director:Agency Phone: 414-803-9674
414-462-3365Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Milwaukee, WI 53218-0324
Rate
NoM.A. Eligible?
10/30/12 Page 35 of 38Printed:
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Vendor List
Tomorrow's Future, LLC Lynell V. Monnie
P.O. Box 18324
Agency Director:Agency Phone: 414-803-9674
414-462-3365Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Milwaukee, WI 53218-0324
Rate
NoM.A. Eligible?
5302 Crisis Bed-Group Home Daily $228.46
5402 Group Home-Specialized Daily $228.46
Totty and Associates Cynthia Totty-Hefley
7251 W. North Avenue
Agency Director:Agency Phone: 414-258-6000
414-258-3700Agency FAX:
Suite 1
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Wauwatosa, WI 53213
Rate
YesM.A. Eligible?
5160 In-Home Lead Medicaid Hour $60.00
5100 Individual/Family Therapy-Office Quarter Hour $16.00
5222A Treatment Plan Meeting Attendance Session $96.00
TransCenter of Nehemiah Project GH (CCC) Marye Beth Dugan
2506 West Vliet Street
Agency Director:Agency Phone: 414-933-8002
414-933-9890Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedMaryE Beth DuganProgram Contact, if any:Milwaukee, WI 53205
Rate
NoM.A. Eligible?
5302 Crisis Bed-Group Home Daily $0.00
5400 Group Home Care Daily $0.00
Trotter House Adrienne Hunter
P.O. Box 091484
Agency Director:Agency Phone: 414-355-9337
414-371-2448Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Milwaukee, WI 53209
Rate
NoM.A. Eligible?
5302 Crisis Bed-Group Home Daily $192.10
5400 Group Home Care Daily $192.10
5403 Group Home Crisis Supervision Hour $70.00
Turcott Medical & Psychiatric Associates Carolyn J. Turcott, M.D.
P.O. Box 180680
Agency Director:Agency Phone: 262-646-6280
414-258-8406Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Delafield, WI 53018
Rate
YesM.A. Eligible?
5000A Assessments-M.D. Session $200.00
5051 Psychiatric Review/Meds-with Therapy Session $150.00
Unity Group Home-Sey&fs (CCC) John Molenaar
8008 W. Capitol Drive
Agency Director:Agency Phone: 414-464-1800
414-464-1804Agency FAX:
Service Code/Description Service Unit
Contact phone: 414-257-7353Cheryl PetersonProgram Contact, if any:Milwaukee, WI 53222
Rate
NoM.A. Eligible?
10/30/12 Page 36 of 38Printed:
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Vendor List
Unity Group Home-Sey&fs (CCC) John Molenaar
8008 W. Capitol Drive
Agency Director:Agency Phone: 414-464-1800
414-464-1804Agency FAX:
Service Code/Description Service Unit
Contact phone: 414-257-7353Cheryl PetersonProgram Contact, if any:Milwaukee, WI 53222
Rate
NoM.A. Eligible?
5400 Group Home Care Daily $0.00
University of Fine Arts, LLC Beverley Moore
7370 N. Bishop Circle
Agency Director:Agency Phone: 414-395-7235
414-395-7233Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Milwaukee, WI 53224
Rate
NoM.A. Eligible?
5130 Special Therapy Quarter Hour $16.00
5222A Treatment Plan Meeting Attendance Session $96.00
Wake Up Program, LLC Alfonzo Watkins MSE, LPC
3353 N. Dr. Martin Luther King Drive
Agency Director:Agency Phone: 414-265-7130
414-265-7131Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Milwaukee, WI 53212
Rate
YesM.A. Eligible?
5160 In-Home Lead Medicaid Hour $60.00
5100 Individual/Family Therapy-Office Quarter Hour $16.00
5222A Treatment Plan Meeting Attendance Session $96.00
Washington House-LSS Dennis Behn
PO Box 88732
Agency Director:Agency Phone: 715-341-7301
715-341-7580Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedMichael ThielProgram Contact, if any:Milwaukee, WI 53288-0732
Rate
NoM.A. Eligible?
5400 Group Home Care Daily $192.10
Wauwatosa Therapies, LLC Jennifer Kebbekus
515 N. Glenview Avenue
Agency Director:Agency Phone: 414-727-5552
414-727-5553Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Wauwatosa, WI 53213
Rate
YesM.A. Eligible?
5135 Occupational Therapy Quarter Hour $20.00
5222A Treatment Plan Meeting Attendance Session $96.00
Wiedel, Timothy C., Ph.D. Timothy C. Wiedel
7251 W. North Avenue
Agency Director:Agency Phone: 414-248-2554
414-302-4620Agency FAX:
Suite 5
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Wauwatosa, WI 53213
Rate
NoM.A. Eligible?
5111A Individual/Family Therapy Lic. Psychologist-Office Session $100.00
5180B Psychological Eval. Extended-Ph.D. Dollar $1.00
5180A Psychological Evaluation Services-Ph.D. Evaluation $350.00
10/30/12 Page 37 of 38Printed:
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Vendor List
Willowglen Academy-Hein Foster Care Group
Home
LaKelvin Hill
1744 North Farwell Avenue
Agency Director:Agency Phone: 414-527-6970
414-225-4475Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Milwaukee, WI 53203
Rate
NoM.A. Eligible?
5302 Crisis Bed-Group Home Daily $165.00
5402 Group Home-Specialized Daily $165.00
Willowglen Community Care Nathan Zeiger
1744 N. Farwell Avenue
Agency Director:Agency Phone: 414-257-6210
414-257-6211Agency FAX:
Service Code/Description Service Unit
Contact phone: None listedNo program contact listedProgram Contact, if any:Milwaukee, WI 53202
Rate
YesM.A. Eligible?
6001 Audit Recoveries Dollar $1.00
5500A Care Coordination-Daily Daily $26.50
5172 Day Treatment (Medicaid-day) Daily $112.00
5580 Discretionary Funds Total $1.00
5100 Individual/Family Therapy-Office Quarter Hour $16.00
5050 Psychiatric Review/Meds Session $80.00
5340 Residential Care Center for Children & Youth Daily $264.66
5344 Residential Short-Term Stabilization Daily $183.75
5412 Respite, Residential Daily $137.45
5222A Treatment Plan Meeting Attendance Session $96.00
Wyalusing Academy-Clinicare Corp Mary Beth Specht
P.O. Box 269
Agency Director:Agency Phone: 608-326-6481
608-326-6166Agency FAX:
Service Code/Description Service Unit
Contact phone: 608-326-6481Rad ReillyProgram Contact, if any:Prairie Du Chien, WI 53821
Rate
NoM.A. Eligible?
5340 Residential Care Center for Children & Youth Daily $308.48
5345 Residential Care-Specialized Daily $318.18
5412 Respite, Residential Daily $139.20
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