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 | 103T00000X | Psychologist | | 3955 | WISCONSIN | No |
| 2 | 103TB0200X | Psychologist | Cognitive & Behavioral | 3955 | WISCONSIN | No |
| 3 | 103TP2701X | Psychologist | Group Psychotherapy | 3955 | WISCONSIN | No |
| 4 | 103TC0700X | Psychologist | Clinical | 3955 | 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 | 1598300972 | OTHER | WISCONSIN | NORTHERN ROOTS COUNSELING |
| 2 | 1609890391 | OTHER | WISCONSIN | RED OAK COUNSELING |
| 3 | 1669599361 | OTHER | WISCONSIN | UNIVERSITY COUNSELING SERVICES |
| 4 | 1114140563 | OTHER | WISCONSIN | HARMONIA MADISON CENTER FOR PSYCHOTHERAPY |
| 5 | 1114920048 | OTHER | WISCONSIN | UNITYPOINT MERITER |
| 6 | 1306991682 | OTHER | WISCONSIN | PRAIRIE COUNSELING SERVICES |
| 7 | 1326282666 | OTHER | WISCONSIN | CIRCLE OF STONES WELLNESS |
| 8 | 1033127246 | OTHER | WISCONSIN | CORNERSTONE COUNSELING SERVICES |
| 9 | 1235646647 | OTHER | WISCONSIN | ABEGGLEN COUNSELING |
| 10 | 1124545199 | OTHER | WISCONSIN | SYNERGOS COUNSELING |
| 11 | 1366481749 | OTHER | WISCONSIN | INTEGRAL PSYCHOLOGY |
| 12 | 1487683694 | OTHER | WISCONSIN | UW HEALTH |
| 13 | 1679755987 | OTHER | WISCONSIN | LAKE CITY COUNSELING |
| 14 | 1093911257 | OTHER | WISCONSIN | JOURNEY MENTAL HEALTH - MENDOTA ST |
| 15 | 1578143327 | OTHER | WISCONSIN | RED WILLOW THERAPY |
| 16 | 1720586761 | OTHER | WISCONSIN | ANESIS CENTER FOR MARRIAGE AND FAMILY THERAPY |
| 17 | 1841413879 | OTHER | WISCONSIN | COLUMBIA COUNTY CSP - JOURNEY MENTAL HEALTH |
| 18 | 1053358846 | OTHER | WISCONSIN | SSM DEAN HEALTH SYSTEMS |
| 19 | 1174720809 | OTHER | WISCONSIN | JOURNEY MENTAL HEALTH - OLIN AVE |
| 20 | 1063619799 | OTHER | WISCONSIN | JOURNEY MENTAL HEALTH - GORHAM ST |
| 21 | 1558930131 | OTHER | WISCONSIN | WI HEALTH OPERATIONS |
| 22 | 1841413879 | OTHER | WISCONSIN | KESSEL COURT CAMPUS JOURNEY PROGRAMS |
| 23 | 1215068069 | OTHER | WISCONSIN | OPEN DOOR CENTER FOR CHANGE |
| 24 | 1629275359 | OTHER | WISCONSIN | JOURNEY MENTAL HEALTH - MAIN ST |
