DR. MICHAEL J VITACCO (NPI# 1063653954) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063653954 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL J VITACCO |
| Credential | PH.D. |
| Practice Address |
301 Troy Dr Madison WI 53704-1521 |
| Practice Telephone | 6083011000 |
| Mailing Telephone | 6083011000 |
| Enumeration Date | 2009-03-23 |
| Last Update Date | 2009-03-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TF0200X |
Psychologist Specialization: Forensic |
2794-57 | WI | Behavioral Health & Social Service Providers |
| Street Address |
301 TROY DR |
| City | MADISON |
| State | WI |
| Zip Code | 53704-1521 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629044797 | Michael T Witkovsky | Psychiatry & Neurology | 301 Troy Dr, Madison, WI 53704-1521 | 2006-02-27 |
| 1790311017 | Joshua Seth Camins | Psychologist | 301 Troy Dr, Madison, WI 53704-1521 | 2020-03-18 |
| 1316583909 | Thomas A Deboer | Psychologist | 301 Troy Dr, Madison, WI 53704-1521 | 2019-11-19 |
| 1811531155 | Kristin A Johnson | Psychologist | 301 Troy Dr, Madison, WI 53704-1521 | 2019-10-30 |
| 1861912958 | Emily Peissig | Counselor | 301 Troy Dr, Madison, WI 53704-1521 | 2017-06-21 |
| 1275083958 | Caroline Carr | Psychologist | 301 Troy Dr, Madison, WI 53704-1521 | 2016-10-06 |
| 1427429653 | Samantha Marsh | Pharmacist | 301 Troy Dr, Madison, WI 53704-1521 | 2015-10-14 |
| 1770840118 | Adrea Hahn Mcglynn | Psychologist | 301 Troy Dr, Madison, WI 53704-1521 | 2012-04-23 |
| 1861636672 | St. Charles Youth & Family Services | Clinic/Center | 301 Troy Dr, Cottage A, Madison, WI 53704-1521 | 2009-04-23 |
| 1073770731 | Krista A Rasmussen | Social Worker | 301 Troy Dr, Cottage B, Madison, WI 53704-1521 | 2008-05-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407369614 | Joseph Michael Oakley II | Chiropractor | 2801 International Ln Ste 102, Madison, WI 53704 | 2017-11-09 |
| 1972015048 | Suzanne Lee | Psychiatry & Neurology | 1835 Winnebago St. #402, Madison, WI 53704 | 2017-10-30 |
| 1831554021 | Gideon Kazah | Licensed Practical Nurse | 2488 Dahle Street, Madison, WI 53704 | 2015-12-15 |
| 1174952220 | Group Health Cooperative of South Central Wisconsin Madison College | Durable Medical Equipment & Medical Supplies | 1705 Hoffman Street, Madison, WI 53704 | 2013-11-08 |
| 1407190127 | Ashley Marie Snyder | Social Worker | 5203 Autumn Leaf Lane, Apt. 389, Madison, WI 53704 | 2012-11-19 |
| 1619230638 | Dawn Lynette Butts | Optometrist | 4208 E Washington Ave, Madison, WI 53704 | 2012-06-25 |
| 1679865992 | Sharon Kelley | Psychologist | 1213 N. Sherman Ave, Suite 334, Madison, WI 53704 | 2011-05-04 |
| 1578730412 | St. Charles Youth & Family Services | Community Based Residential Treatment Facility, Mental Illness | 310 Troy Dr, Cottage B, Madison, WI 53704 | 2008-05-09 |
| 1538346960 | Elizabeth Ann Reiser-loeber | Dentist | 1001 N. Sherman Ave, Madison, WI 53704 | 2008-01-28 |
| 1861683088 | Stephen Dale Flach | Internal Medicine | Covance, 3402 Kinsman Blvd, Madison, WI 53704 | 2007-08-05 |
| Find all providers in zip 53704 | ||||
| Taxonomy Code | 103TF0200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Forensic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679127278 | Akillah Jamillah Wali | Psychologist | 6417 Odana Rd Suite 5, Madison, WI 53719 | 2019-07-31 |
| 1962529032 | James Demetrius Tomony I | Psychologist | 301 Troy Dr, Madison, WI 53704-1521 | 2007-03-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861015216 | Andrew Montgomery Simcox X | Psychologist | Unified Community Services, 200 West Alona Lane, Lancaster, WI 53813 | 2020-05-20 |
| 1154766004 | Suzanne J. Lisowski | Psychologist | 2230 S Kinnickinnic Ave, Milwaukee, WI 53207-1330 | 2013-05-06 |
| 1750627378 | Deborah Collins | Psychologist | 740 N Plankinton Ave, Suite 334, Milwaukee, WI 53203-2403 | 2012-12-31 |
Please comment or provide details below to improve the information on DR. MICHAEL J VITACCO.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.