Provider Demographics
NPI:1023519956
Name:STRATA PSYCHOTHERAPY & ADHD SERVICES, LLC
Entity type:Organization
Organization Name:STRATA PSYCHOTHERAPY & ADHD SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:MATZ
Authorized Official - Suffix:
Authorized Official - Credentials:MS MFT-IT
Authorized Official - Phone:608-577-6289
Mailing Address - Street 1:733 STRUCK ST UNIT 45031
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53744-3636
Mailing Address - Country:US
Mailing Address - Phone:608-577-6289
Mailing Address - Fax:
Practice Address - Street 1:6701 SEYBOLD RD STE 114
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53719-1388
Practice Address - Country:US
Practice Address - Phone:608-577-6289
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-26
Last Update Date:2018-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
14001869OtherCAQH