ROGER MACK PUMPHREY MA LPC NPI 1669672945

NPI Information

NPI: 1669672945
Provider Name: ROGER MACK PUMPHREY, MA, LPC
Classification: Counselor - 101YM0800X
Entity Type: Individual

Specialization: Mental Health

Address:
6040 W LISBON AVE
SUITE 102
MILWAUKEE, WI
ZIP 53210
Phone: (414) 871-9111
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Roger Mack Pumphrey, MA, LPC is a mental health counselor in Milwaukee, WI. Roger Mack Pumphrey, MA, LPC NPI is 1669672945. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

6040 W LISBON AVE
SUITE 102
MILWAUKEE, WI
ZIP 53210-116
Phone: (414) 871-9111
Fax: (414) 871-9121

The enumeration date for this NPI number is 7/24/2007 and was last updated on 7/24/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YP2500X	Counselor	Professional	1157-132	WISCONSIN	No
2	101YM0800X	Counselor	Mental Health	1328-125	WISCONSIN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	39668000	MEDICAID	WISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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