LISA M NACKERS (NPI# 1225435274) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225435274 |
| Entity Type | Individual |
| Full Name | LISA M NACKERS |
| Credential | PHD, MPH |
| Practice Address |
4602 Eastpark Blvd Madison WI 53718-2002 |
| Mailing Address |
4602 Eastpark Blvd Mail Code Ac05 Madison WI 53718-2002 |
| Practice Telephone | 6082657090 |
| Practice Fax Number | 6082346695 |
| Mailing Telephone | 6082657090 |
| Mailing Fax Number | 6082346695 |
| Enumeration Date | 2014-11-19 |
| Last Update Date | 2019-11-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | 3259 | WI | Behavioral Health & Social Service Providers |
| N | 103TC0700X |
Psychologist Specialization: Clinical |
071-008908 | IL | Behavioral Health & Social Service Providers |
| Street Address |
4602 EASTPARK BLVD |
| City | MADISON |
| State | WI |
| Zip Code | 53718-2002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619944238 | Douglas B Chapman | Internal Medicine | 4602 Eastpark Blvd, Madison, WI 53718-2002 | 2006-03-02 |
| 1790383321 | Kelli M Notaro | Nurse Practitioner | 4602 Eastpark Blvd, Madison, WI 53718-2002 | 2020-10-15 |
| 1346865581 | Bethany A. Meyering | Anesthesiologist Assistant | 4602 Eastpark Blvd, Madison, WI 53718-2002 | 2020-06-13 |
| 1831713726 | Rachael Makamae Maguire | Physical Therapist | 4602 Eastpark Blvd, Madison, WI 53718-2002 | 2020-06-05 |
| 1619590726 | Amanda S. Phillips | Psychologist | 4602 Eastpark Blvd, Madison, WI 53718-2002 | 2020-05-22 |
| 1699301143 | Stephanie Chang | Pharmacist | 4602 Eastpark Blvd, Madison, WI 53718-2002 | 2020-03-17 |
| 1154967123 | Bailey Elizabeth Higby | Nurse Practitioner | 4602 Eastpark Blvd, Madison, WI 53718-2002 | 2019-11-25 |
| 1538716725 | Jessica Lynn Flood | Orthopaedic Surgery | 4602 Eastpark Blvd, Madison, WI 53718-2002 | 2019-08-22 |
| 1619524071 | Ella Cait Husom | Specialist/Technologist | 4602 Eastpark Blvd, Madison, WI 53718-2002 | 2019-08-21 |
| 1386296853 | Olivia Rowland | Physical Therapist | 4602 Eastpark Blvd, Madison, WI 53718-2002 | 2019-07-15 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609475607 | Suchart Thammahong | Pharmacist | 734 Mclean Drive, Madison, Wi, WI 53718 | 2020-10-21 |
| 1780033431 | Elizabeth C Armstrong | Registered Nurse | 2810 Crossroads Dr Ste 4000, Madison, WI 53718 | 2016-06-03 |
| 1811356926 | Quirt Family Dentistry, Sc | Dentist | 6038 Gemini Drive, Madison, WI 53718 | 2016-02-17 |
| 1831583145 | Madison Rehabilitation Hospital, LLC | Rehabilitation Hospital | 5115 N Biltmore Ln, Madison, WI 53718 | 2015-03-25 |
| 1972919959 | Hannah E Kussler | Physician Assistant | The American Center, 4602 Eastpark Blvd, Madison, WI 53718 | 2014-07-10 |
| 1104187079 | Kaitlin Hellenbrand | Occupational Therapist | 5249 East Terrace Drive, Madison, WI 53718 | 2012-06-06 |
| 1003172800 | Wisconsin Hyperbaric Oxygen LLC | Clinic/Center | 4660 S Biltmore Lane, Madison, WI 53718 | 2012-04-05 |
| 1801022850 | Justin Robert Bangert | Marriage & Family Therapist | 5310 Wall St., Ste #500, Madison, WI 53718 | 2009-06-04 |
| 1427292275 | Jane Louise Stroede | Physical Therapy Assistant | 2802 Walton Commons West, Madison, WI 53718 | 2009-04-23 |
| 1003060658 | Candace Leigh Pantoga | Occupational Therapist | 3030 City View Drive, City View Nursing Home, Madison, WI 53718 | 2008-11-10 |
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| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073138327 | Rachel Kahn | Psychologist | 501 Acacia Ln, Madison, WI 53716-3238 | 2020-06-12 |
| 1700363652 | Capital City Psychology, LLC | Psychologist | 313 Price Pl Ste 210, Madison, WI 53705-3262 | 2018-07-24 |
| 1093222010 | Leya Moore | Psychologist | 1415 Rutledge St, Madison, WI 53703-3834 | 2017-12-29 |
| 1306359591 | Elizabeth Gaebler | Psychologist | 700 Ray O Vac Dr Ste 114, Madison, WI 53711-2468 | 2017-11-09 |
| 1619489135 | Streicher-bremer Psychotherapy Sc | Psychologist | 1619 Monroe St Ste 2, Madison, WI 53711-2063 | 2017-10-25 |
| 1356736565 | Madison Behavioral Psychology, LLC | Psychologist | 7818 Big Sky Dr Ste 210, Madison, WI 53719-3524 | 2015-04-03 |
| 1457756595 | Familypath Autism Services, LLC | Psychologist | 575 Donofrio Dr Ste 101, Madison, WI 53719-2832 | 2014-10-31 |
| 1104184142 | Hurd Counseling and Educational Psychology | Psychologist | 700 Rayovac Drive, Madison, WI 53711 | 2012-04-27 |
| 1679865992 | Sharon Kelley | Psychologist | 1213 N. Sherman Ave, Suite 334, Madison, WI 53704 | 2011-05-04 |
| 1225342280 | Daniel P. Davis | Psychologist | 7601 Ganser Way, 2nd Floor Suite, Madison, WI 53719-2074 | 2010-08-02 |
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| 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.