PSYCHOLOGY CLINIC INC. (NPI# 1336222769) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336222769 |
| Entity Type | Organization |
| Organization Name | PSYCHOLOGY CLINIC INC. |
| Practice Address |
310 N Midvale Blvd Ste 202 Madison WI 53705-3265 |
| Practice Telephone | 6088528585 |
| Practice Fax Number | 6082381929 |
| Mailing Telephone | 6088528585 |
| Mailing Fax Number | 6082381929 |
| Enumeration Date | 2006-10-21 |
| Last Update Date | 2010-10-25 |
| Authorized Official Name | DR. DAVID ROETHE (PSYCHOLOGIST/CO-DIRECTOR) |
| Authorized Official Telephone | 6082806486 |
| Authorized Official Credential | PH.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | 1919 | WI | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 42161100 | 05 |
| Street Address |
310 N MIDVALE BLVD STE 202 |
| City | MADISON |
| State | WI |
| Zip Code | 53705-3265 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659971224 | Katherine Goerman | Marriage & Family Therapist | 310 N Midvale Blvd Ste 202, Madison, WI 53705-3265 | 2020-10-31 |
| 1982240362 | Chloe M Moore | Social Worker | 310 N Midvale Blvd Ste 202, Madison, WI 53705-3265 | 2019-11-21 |
| 1265705842 | Andrea Nelson | Psychologist | 310 N Midvale Blvd Ste 202, Madison, WI 53705-3265 | 2012-02-13 |
| 1063639946 | Laurie Ann Asplund | Counselor | 310 N Midvale Blvd Ste 202, Madison, WI 53705-3265 | 2007-04-20 |
| 1477608487 | Jane Bartels | Counselor | 310 N Midvale Blvd Ste 202, Madison, WI 53705-3265 | 2007-01-23 |
| 1548338239 | David Roethe | Psychologist | 310 N Midvale Blvd Ste 202, Madison, WI 53705-3265 | 2006-12-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629563986 | Magdalena Maria Siodlak | Pharmacist | 2500 Overlook Terrace (119), Madison, WI 53705 | 2018-06-28 |
| 1104343243 | Aisling Margaret Tallman | Physician Assistant | 725 University Row, Apt 124, Madison, WI 53705 | 2017-08-29 |
| 1346785938 | Rachel Maria Sanabria | Social Worker | 4513 Vernon Blvd Ste 100, Madison, WI 53705 | 2017-01-05 |
| 1124482856 | Samantha Jo Juve | Social Worker | 313 Price Pl Ste 212, Madison, WI 53705 | 2016-04-08 |
| 1912373002 | Brittany Dennis | Counselor | 5005 University Avenue, Suite 100, Madison, WI 53705 | 2015-08-12 |
| 1225456981 | John Martin Floberg | Radiology | 2140, Med 4 Mailbox, Hslc, 750 Highland Ave., Madison, WI 53705 | 2014-03-31 |
| 1457693319 | Matthew Ryan May-curry | Psychiatry & Neurology | 2500 Overlook Ter # 116a, Madison, WI 53705 | 2013-03-19 |
| 1396083168 | Madison Psychiatric & Psychological Services | Psychiatry & Neurology | 702 N. Blackhawk Ave, #100, Madison, WI 53705 | 2013-01-29 |
| 1174872808 | Natasha Bulat | Massage Therapist | 5317 Old Middleton Rd, Room #102, 'hot Stone Therapy & Massage', Madison, WI 53705 | 2012-09-10 |
| 1033401609 | Ann B Braus | Family Medicine | 6209 Mineral Point Rd, Madison, WI 53705 | 2011-05-13 |
| Find all providers in zip 53705 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
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| 1619926854 | Target Pharmacy T-1060 | Clinic/Center | 201 Junction Rd, Madison, WI 53717-2615 | 2006-05-06 |
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| 1467088542 | Peak Performance Chiropractic and Rehab LLC | Clinic/Center | 132 Alton Dr, Madison, WI 53718-9156 | 2020-03-20 |
| Find all providers in MADISON | ||||
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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.