NEUROPSYCHOLOGICAL SERVICES OF SOUTHEASTERN WISCONSIN, LTD (NPI# 1053953984) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053953984 |
| Entity Type | Organization |
| Organization Name | NEUROPSYCHOLOGICAL SERVICES OF SOUTHEASTERN WISCONSIN, LTD |
| Practice Address |
200 S Executive Dr Brookfield WI 53005-4216 |
| Mailing Address |
1132 S Waterville Lake Rd Oconomowoc WI 53066-8401 |
| Practice Telephone | 2627514499 |
| Practice Fax Number | 2623034146 |
| Mailing Telephone | 2627514499 |
| Mailing Fax Number | 2623034146 |
| Enumeration Date | 2019-10-11 |
| Last Update Date | 2019-10-11 |
| Authorized Official Name | PAMELA J MCMURRAY (OWNER) |
| Authorized Official Telephone | 2627514499 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2717 N Grandview Blvd Ste 202, Waukesha, WI 531881660 | 2627514499 |
| Street Address |
200 S EXECUTIVE DR |
| City | BROOKFIELD |
| State | WI |
| Zip Code | 53005-4216 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326079716 | Jeffrey L. Morer, Od, PC | Optometrist | 200 S Executive Dr, Suite 101, Brookfield, WI 53005-4216 | 2006-07-05 |
| 1174140115 | Krista Lyn Fogltanz | Audiologist | 200 S Executive Dr, Brookfield, WI 53005-4216 | 2020-06-25 |
| 1265968036 | Crystal Avery | In Home Supportive Care | 200 S Executive Dr, Suite 101, Brookfield, WI 53005-4216 | 2017-05-11 |
| 1275914483 | Legacy Physiatry Group Wisconsin, LLC | Internal Medicine | 200 S Executive Dr, Suite 101, Brookfield, WI 53005-4216 | 2015-06-12 |
| 1629377676 | Maria Christine Jenkins | Dental Hygienist | 200 S Executive Dr, Suite 101, Brookfield, WI 53005-4216 | 2011-03-16 |
| 1124338462 | Genevieve Pressman | Pedorthist | 200 S Executive Dr, Suite 101, Brookfield, WI 53005-4216 | 2010-10-20 |
| 1679886915 | Natasha Marie Ming | Dental Hygienist | 200 S Executive Dr, Suite 101, Brookfield, WI 53005-4216 | 2010-07-15 |
| 1447589783 | Ryan R. Blair | Hearing Instrument Specialist | 200 S Executive Dr, Suite 101, Brookfield, WI 53005-4216 | 2009-12-16 |
| 1679802409 | Impressions of Increase, Inc. | In Home Supportive Care | 200 S Executive Dr, Suite 101, Brookfield, WI 53005-4216 | 2009-12-07 |
| 1114157955 | Demetria Martin | Podiatrist | 200 S Executive Dr, Suite 101, Brookfield, WI 53005-4216 | 2009-07-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154937621 | Nsk Precision Healing & Wellness | Acupuncturist | 17040 W. Greenfield Ave #6, Brookfield, WI 53005 | 2020-09-21 |
| 1033772124 | Dbt Consultants LLC | Social Worker | 200 S. Executive Drive, Ste. 101, Brookfield, WI 53005 | 2019-04-15 |
| 1780142588 | Ashley Wing | Registered Nurse | 405 Bishops Way, Apt 555, Brookfield, WI 53005 | 2019-03-11 |
| 1407370398 | Tombolo, LLC | Clinic/Center | 12545 W. Burleigh Rd., Suite 10, Brookfield, WI 53005 | 2017-08-01 |
| 1720509045 | Rss William Conner LLC | Dentist | 15455 W Bluemound Rd Ste 250, Brookfield, WI 53005 | 2017-06-28 |
| 1669926598 | Mackenzie Rondeau | Physical Therapist | 1905 N Calhoun Rd Ste 105, Brookfield, WI 53005 | 2016-08-09 |
| 1699159319 | Charles Alan Kass | Dentist | 12720 W. North Avenue, Brookfield, WI 53005 | 2015-07-13 |
| 1164804274 | Mary-catherine Nimphius | Counselor | 250 S. Sunny Slope Rd, #128, Brookfield, WI 53005 | 2015-06-25 |
| 1528447034 | Weighless Md, LLC | Dietitian, Registered | 14960 W. Greenfield Ave Suite 104, Brookfield, WI 53005 | 2015-05-29 |
| 1366837346 | Maegan Michelle Cook | Dentist | 13780 W Greenfield Ave Ste 780, Brookfield, WI 53005 | 2015-04-06 |
| Find all providers in zip 53005 | ||||
| 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 |
|---|---|---|---|---|
| 1144561051 | Western Connecticut Behavioral Health | Clinical Neuropsychologist | 828 Federal Rd, 2nd Floor, Brookfield, CT 06804-1830 | 2013-03-04 |
| 1902456569 | Neuropsychological Services of Southeastern Wisconsin,ltd | Clinical Neuropsychologist | 200 S Executive Dr Ste 101, Brookfield, WI 53005-4216 | 2019-09-16 |
| 1184873721 | Jessica Danielle Biren Caverly | Clinical Neuropsychologist | 2 Old New Milford Rd, 1e, Brookfield, CT 06804-2426 | 2008-09-18 |
| 1114098704 | Pamela J Mcmurray | Clinical Neuropsychologist | 200 S Executive Dr Ste 101, Brookfield, WI 53005 | 2006-11-13 |
| 1922180736 | Robert Bronson Levin | Clinical Neuropsychologist | 16535 W Bluemound Rd, # 200, Brookfield, WI 53005-5936 | 2006-10-20 |
| 1679524250 | Katherine Rogers Burrows | Clinical Neuropsychologist | 13800 W North Ave, Child Development Center of Chw, Brookfield, WI 53005-4977 | 2006-05-16 |
| 1073588505 | Diana Badillo Martinez | Clinical Neuropsychologist | 60 Old New Milford Rd, Suite 3d, Brookfield, CT 06804-2430 | 2006-02-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578023156 | Midway Clinical Neuropsychologic Institute and Children's Wellness Fou | Clinical Neuropsychologist | 1024 60th Street, Suite 5, Kenosha, WI 53140-4099 | 2019-03-21 |
| 1114449949 | Tobias D Kaemmerer | Clinical Neuropsychologist | 2901 W Kinnickinnic River Pkwy Ste 417, Milwaukee, WI 53215-3660 | 2017-07-13 |
| 1972989804 | Anne L Shandera-ochsner | Clinical Neuropsychologist | 212 11th Street, La Crosse, WI 54601 | 2015-08-03 |
| 1891054441 | Mary Christine Majors | Clinical Neuropsychologist | 625 Wildlife Dr, Fond Du Lac, WI 54937-7708 | 2012-05-16 |
| 1821360199 | Tiffany M Jacobsen | Clinical Neuropsychologist | 2448 S 102nd St Ste 270, Milwaukee, WI 53227-2147 | 2012-02-02 |
| 1861625220 | Rebecca L Torres | Clinical Neuropsychologist | 721 American Ave Ste 406, Waukesha, WI 53188-5071 | 2009-09-01 |
| 1336319979 | Shellie Dee Locke | Clinical Neuropsychologist | 9020 15th Ave, Kenosha, WI 53143-6803 | 2008-03-11 |
| 1538352935 | Robert George Owens | Clinical Neuropsychologist | 2653 Statdust Trail, Verona, WI 53593-9714 | 2007-08-20 |
| 1720278005 | Judith Davis | Clinical Neuropsychologist | 716 Roby Rd, Stoughton, WI 53589 | 2007-08-01 |
| 1821201930 | Bonita P Klein-tasman | Clinical Neuropsychologist | 2441 E Hartford Ave, Garland 210, Milwaukee, WI 53211-3160 | 2007-05-07 |
| Find all providers with the same taxonomy | ||||
| City | BROOKFIELD |
| Zip Code | 53005 |
Please comment or provide details below to improve the information on NEUROPSYCHOLOGICAL SERVICES OF SOUTHEASTERN WISCONSIN, LTD.
| 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.