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CLINICAL PSYCHOLOGY ASSOCIATES LLC NPI 1619156502


NPI Information

NPI: 1619156502
Provider Name: CLINICAL PSYCHOLOGY ASSOCIATES, LLC

Doing Business As: CLINICAL PSYCHOLOGY ASSOCIATES

Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

Address:
197 W CHESTNUT ST STE 100
BURLINGTON, WI
ZIP 53105
Phone: (262) 763-9191
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CLINICAL PSYCHOLOGY ASSOCIATES, LLC is a mental health (including community mental health center) clinic center in Burlington, WI. CLINICAL PSYCHOLOGY ASSOCIATES, LLC NPI is 1619156502. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Clinical Psychology Associates.

The provider's business location address is:

197 W CHESTNUT ST STE 100
BURLINGTON, WI
ZIP 53105-200
Phone: (262) 763-9191
Fax: (262) 763-7767

The provider's authorized official is David William Thompson .
The authorized official title is Clinic Director/owner and has the following contact phone number (262) 763-9191.

The enumeration date for this NPI number is 10/29/2007 and was last updated on 4/22/2021.


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
1103T00000XPsychologistNo
2103TC0700XPsychologistClinical1588WISCONSINNo
3261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)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
142171100MEDICAIDWISCONSIN

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: 5/5/2024

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