PSYCHIATRIC SERVICES OF RACINE, LLP (NPI# 1699791988) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699791988 |
| Entity Type | Organization |
| Organization Name | PSYCHIATRIC SERVICES OF RACINE, LLP |
| Practice Address |
8700 Durand Ave Ste 600 Sturtevant WI 53177-2096 |
| Practice Telephone | 2626355520 |
| Practice Fax Number | 2626355530 |
| Mailing Telephone | 2626355520 |
| Mailing Fax Number | 2626355530 |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2018-03-27 |
| Authorized Official Name | DR. WILLIAM J BJERREGAARD (PARTNER) |
| Authorized Official Telephone | 2626355520 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TP0016X |
Psychologist Specialization: Prescribing (Medical) |
1757 | WI | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 42166000 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1244 Wisconsin Ave Ste 303, Racine, WI 534031987 | 2626355520 | 2626355530 |
| Street Address |
8700 DURAND AVE STE 600 |
| City | STURTEVANT |
| State | WI |
| Zip Code | 53177-2096 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629065404 | Ahmad Zia Khan | Psychiatry & Neurology | 8700 Durand Ave Ste 600, Sturtevant, WI 53177-2096 | 2005-10-05 |
| 1063409852 | David L Nichols | Psychologist | 8700 Durand Ave Ste 600, Sturtevant, WI 53177-2096 | 2005-10-05 |
| 1275520033 | Robert Stephen Callaghan | Psychiatry & Neurology | 8700 Durand Ave Ste 600, Sturtevant, WI 53177 | 2005-10-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710170626 | Lawrence Volkert | Dentist | 2753 Wisconsin Street, Sturtevant, WI 53177 | 2007-08-23 |
| 1023171279 | Lucy Mcauley | Physical Therapist | 8700 Durand Ave, Suite D, Sturtevant, WI 53177 | 2006-12-19 |
| 1245585462 | Amrinder Singh | Family Medicine | 10340 Washington Ave, Sturtevant, WI 53177 | 2012-07-14 |
| 1083748255 | Sean P Sheerin | Physical Therapy Assistant | 8700 Durand Ave, Suite 100, Sturtevant, WI 53177 | 2007-03-16 |
| 1083748271 | Paula J Hatch | Occupational Therapist | 8700 Durand Ave, Suite 100, Sturtevant, WI 53177 | 2007-03-16 |
| 1740518869 | Arlene C Adams | Physical Therapist | 515 Deer Path, Sturtevant, WI 53177-1266 | 2009-12-01 |
| 1013548833 | Ascension Wisconsin Surgery Center-mount Pleasant LLC | Clinic/Center | 10180 Washington Ave Ste 200, Mount Pleasant, WI 53177-1604 | 2020-01-30 |
| 1184254336 | Kristiana R Maggard | Occupational Therapist | 10180 Washington Ave # 107, Mount Pleasant, WI 53177-1604 | 2020-01-16 |
| 1851939037 | Ascension Wisconsin Pharmacy, Inc | Pharmacy | 10180 Washington Ave Ste 102, Mount Pleasant, WI 53177-1604 | 2019-12-18 |
| 1447897004 | Mary Nilles | Physical Therapist | 10180 Washington Ave, Mount Pleasant, WI 53177-1604 | 2019-12-03 |
| Find all providers in zip 53177 | ||||
| Taxonomy Code | 103TP0016X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Prescribing (Medical) |
| Those licensed psychologists who have completed specialized, post-doctoral training in psychopharmacology, passed a national proficiency examination in psychopharmacology, and who are authorized by state statute to prescribe medications, in accordance with their state law and state licensing authority, for the evaluation, diagnosis, management and treatment of mental, nervous, emotional, behavioral, and related disorders. |
| Notes: Source: Louisiana Academy of Medical Psychologists Note: Some states issue licenses under Medical Psychologist. [1/1/2007: new] |
| City | STURTEVANT |
| Zip Code | 53177 |
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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.