NORTHERN WISCONSIN GERIATRIC PSYCHOLOGICAL SERVICES, SC (NPI# 1578955134) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578955134 |
| Entity Type | Organization |
| Organization Name | NORTHERN WISCONSIN GERIATRIC PSYCHOLOGICAL SERVICES, SC |
| Practice Address |
859 Chaplin Ct Plymouth WI 53073-1012 |
| Mailing Address |
Po Box 750834 Forest Hills NY 11375-0834 |
| Practice Telephone | 9208938000 |
| Mailing Telephone | 7182686600 |
| Mailing Fax Number | 7182686065 |
| Enumeration Date | 2015-02-19 |
| Last Update Date | 2015-02-19 |
| Authorized Official Name | DR. CONSTANCE L WOYTHAL (OWNER) |
| Authorized Official Telephone | 9208938000 |
| Authorized Official Credential | PSYD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
2322-57 | WI | Behavioral Health & Social Service Providers |
| Street Address |
859 CHAPLIN CT |
| City | PLYMOUTH |
| State | WI |
| Zip Code | 53073-1012 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275656084 | Constance Lee Woythal | Psychologist | 859 Chaplin Ct, Plymouth, WI 53073-1012 | 2007-04-08 |
| 1750726469 | Mary M Lemay | Counselor | 859 Chaplin Ct, Plymouth, WI 53073-1012 | 2013-05-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245889914 | Patricia M. Stone | Technician | 440 Stoneybrook Lane, Plymouth, WI 53073 | 2019-09-05 |
| 1801387501 | Kwon Yang | Dentist | W 9071 Forest Drive, Plymouth, WI 53073 | 2018-05-29 |
| 1396258752 | Advanced Dental Care Clinic Sc | Clinic/Center | 62 S Pleasant View Road, Plymouth, WI 53073 | 2017-11-08 |
| 1164888004 | Lukresse Tatiana Kouam Tchuendem | Registered Nurse | 236 N Milwaukee St, Plymoth, WI 53073 | 2016-01-07 |
| 1831447424 | Lori Ann Schuette | Registered Nurse | 406 Summit Street, Plymouth, WI 53073 | 2012-08-29 |
| 1821360967 | Kristine Marie Van Ess | Case Manager/Care Coordinator | 7135 Rocky Knoll Pkwy, Plymouth, WI 53073 | 2012-02-06 |
| 1750699708 | Shannon Diamond | Physical Therapist | 825 Walton Drive, Plymouth, WI 53073 | 2010-09-23 |
| 1306088265 | Lacey Lyn Schafer | Nurse Practitioner | W9071 Forest Dr, Plymouth, WI 53073 | 2009-03-24 |
| 1275780868 | Stella D. Kaas-lallensack | Occupational Therapist | W5774 Garton Rd, Plymouth, WI 53073 | 2008-08-26 |
| 1912172248 | Judith A Nelson | Registered Nurse | N7116 County Road E, Plymouth, WI 53073 | 2008-04-28 |
| Find all providers in zip 53073 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790264760 | Tasha Leno | Psychologist | 595 Forest Ave Ste 7a, Plymouth, MI 48170-1777 | 2018-08-10 |
| 1679059968 | Life Improved, LLC | Psychologist | 300 Main Street, Suite 200, Plymouth, NH 03264 | 2018-07-19 |
| 1952891038 | Charles Francis Carroll | Psychologist | 17 Alvin Rd, Plymouth, MA 02360-3920 | 2018-05-15 |
| 1861914863 | Steven Schwartz | Psychologist | 12431 Howland Park Dr, Plymouth, MI 48170-2894 | 2017-07-11 |
| 1366827016 | Juliann Knochel | Psychologist | 42325 Ann Arbor Rd E, Plymouth, MI 48170-4356 | 2015-07-23 |
| 1851781959 | Stephen Mangin | Psychologist | 42245 Ann Arbor Rd E Ste 101, Plymouth, MI 48170-4311 | 2015-01-27 |
| 1649683517 | Heather M Delcourt | Psychologist | 595 Forest Ave Ste 11a, Plymouth, MI 48170-1777 | 2014-06-08 |
| 1952730723 | Amanda Michelle Henderson Bills | Psychologist | 199 N Main St Ste 200, Plymouth, MI 48170-1286 | 2013-11-02 |
| 1255779492 | Heather D Haggerty | Psychologist | 340 N Main St Ste 201, Plymouth, MI 48170-1290 | 2013-06-10 |
| 1164705471 | Ruth C. Rowbotham | Psychologist | 225 Water St Ste A115, Plymouth, MA 02360-4060 | 2011-09-22 |
| Find all providers in PLYMOUTH | ||||
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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.