DONALD LEROY MICKEY (NPI# 1568426278) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568426278 |
| Entity Type | Individual |
| Full Name | DONALD LEROY MICKEY |
| Credential | PH.D. |
| Practice Address |
4785 Hayes Rd Suite 100 Madison WI 53704-7364 |
| Practice Telephone | 6082427160 |
| Practice Fax Number | 6082427153 |
| Mailing Telephone | 6082427160 |
| Mailing Fax Number | 6082427153 |
| Enumeration Date | 2006-04-12 |
| Last Update Date | 2015-06-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | 1612 - 057 | WI | Behavioral Health & Social Service Providers |
| N | 103TC0700X |
Psychologist Specialization: Clinical |
1612 - 057 | WI | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 39096500 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952774101 | Donald Scott Mickey | Counselor | 200 Beatty St, Medford, OR 97501-5811 | 2015-11-10 |
| Street Address |
4785 HAYES RD SUITE 100 |
| City | MADISON |
| State | WI |
| Zip Code | 53704-7364 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154384006 | Brenda Sue Kepler Leske | Psychologist | 4785 Hayes Rd, Suite 100, Madison, WI 53704-7364 | 2006-04-11 |
| 1093256604 | Madison Trauma Therapy, LLC | Counselor | 4785 Hayes Rd, Suite 201, Madison, WI 53704-7364 | 2017-03-15 |
| 1417349689 | Claire Patterson | Psychologist | 4785 Hayes Rd, Suite 100, Madison, WI 53704-7364 | 2015-02-25 |
| 1932145430 | Counseling Resources Neuropsychological Associates, LLC | Counselor | 4785 Hayes Rd, Suite 100, Madison, WI 53704 | 2006-06-22 |
| 1194789206 | Karen Jennifer Bauman | Psychologist | 4785 Hayes Rd, Suite 100, Madison, WI 53704-7364 | 2006-04-14 |
| 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 | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295929461 | Laura Palmer Phd LLC | Clinical Neuropsychologist | 37 Kings Rd Ste 102, Madison, NJ 07940-2500 | 2007-08-30 |
| 1255303475 | Bruce P Hermann | Clinical Neuropsychologist | 600 Highland Av, Madison, WI 53792 | 2006-02-02 |
| 1053314344 | Gordon I Herz | Clinical Neuropsychologist | 478 Commerce Dr, Ste 204, Madison, WI 53719-4993 | 2005-05-31 |
| 1538792940 | Gloria M Morel Valdes | Clinical Neuropsychologist | 600 Highland Ave, Madison, WI 53792-0001 | 2020-02-14 |
| 1316580517 | Kelly Nicole Morgan | Clinical Neuropsychologist | 1313 Fish Hatchery Rd, Madison, WI 53715-1911 | 2019-10-21 |
| 1548817935 | John Stratton | Clinical Neuropsychologist | 600 Highland Ave, Madison, WI 53792-0001 | 2019-08-21 |
| 1730640178 | Victoria Jade Williams | Clinical Neuropsychologist | 5249 E Terrace Dr, Madison, WI 53718-8339 | 2019-03-28 |
| 1295216430 | Sarah A Vadnais | Clinical Neuropsychologist | 1313 Fish Hatchery Rd, Madison, WI 53715-1911 | 2018-08-26 |
| 1073030961 | Jonathan James Mietchen | Clinical Neuropsychologist | 600 Highland Ave, Madison, WI 53792-9469 | 2017-08-23 |
| 1629519475 | Natalie M Klempel | Clinical Neuropsychologist | 1313 Fish Hatchery Rd, Madison, WI 53715-1911 | 2017-03-13 |
| 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.