DR. JODY ANN PAHLAVAN (NPI# 1093707044) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093707044 |
| Entity Type | Individual |
| Full Name | DR. JODY ANN PAHLAVAN |
| Credential | PSYD |
| Practice Address |
11101 W Lincoln Ave Rogers Memorial Hospital West Allis WI 53227-1133 |
| Mailing Address |
N48w16080 Lone Oak Ln Menomonee Falls WI 53051-7528 |
| Practice Telephone | 4143273000 |
| Mailing Telephone | 2628790022 |
| Enumeration Date | 2005-08-16 |
| Last Update Date | 2017-08-25 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | 1694-057 | WI | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 39229700 | 05 |
| Street Address |
11101 W LINCOLN AVE ROGERS MEMORIAL HOSPITAL |
| City | WEST ALLIS |
| State | WI |
| Zip Code | 53227-1133 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710979984 | Kristin Cromwell Kim | Psychologist | 11101 W Lincoln Ave, Rogers Memorial Hospital, West Allis, WI 53227-1133 | 2005-08-16 |
| 1235746157 | Carol Elizabeth Smith | Nurse Practitioner | 11101 W Lincoln Ave, West Allis, WI 53227-1133 | 2020-09-24 |
| 1447892583 | Joleen Brewer | Nurse Practitioner | 11101 W Lincoln Ave, West Allis, WI 53227-1133 | 2019-10-10 |
| 1659836609 | Herbert C Raasch | Nurse Practitioner | 11101 W Lincoln Ave, West Allis, WI 53227-1133 | 2019-02-04 |
| 1952885337 | Lauren Ramsey Lewis | Counselor | 11101 W Lincoln Ave, West Allis, WI 53227-1133 | 2018-09-20 |
| 1396223897 | Daniel Noll | Counselor | 11101 W Lincoln Ave, West Allis, WI 53227-1133 | 2018-08-06 |
| 1053765289 | Linda Chwierut | Registered Nurse | 11101 W Lincoln Ave, West Allis, WI 53227-1133 | 2016-04-13 |
| 1164819389 | Gillian Greene | Registered Nurse | 11101 W Lincoln Ave, West Allis, WI 53227-1133 | 2015-04-26 |
| 1891100848 | Susan Marie Johnson | Registered Nurse | 11101 W Lincoln Ave, West Allis, WI 53227-1133 | 2014-06-29 |
| 1114262664 | Angela Marie Lewis | Registered Nurse | 11101 W Lincoln Ave, West Allis, WI 53227-1133 | 2012-12-10 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205451564 | Ginger Renee Bland | Nurse Practitioner | 11133 W. National Avenue, West Allis, WI 53227 | 2020-06-12 |
| 1003312141 | Dynamic Medical Equipment, LLC | Durable Medical Equipment & Medical Supplies | 10236 W National Ave, West Allis, WI 53227 | 2018-04-05 |
| 1932572641 | Alissa Kristine Walker | Specialist/Technologist | 11601 W Lincoln Ave, West Allis, WI 53227 | 2015-11-03 |
| 1396155990 | Bradly Earl Helinski | Physical Therapy Assistant | 3023 S 84th St., Milwaukee, WI 53227 | 2014-05-05 |
| 1609299783 | Amy Renee Rozumalski | Occupational Therapy Assistant | 10150 W. National Ave, Suite 150, Premiere Medical Staffing Services, LLC, Milwaukee, WI 53227 | 2014-01-27 |
| 1497098438 | Kathleen Marie Schneider | Physical Therapy Assistant | 3023 S. 84th Street, Milwaukee, WI 53227 | 2013-03-28 |
| 1760723373 | Lee Ann Schraith | Physical Therapy Assistant | 3023 S. 84th St, Milwaukee, WI 53227 | 2013-03-06 |
| 1740520725 | Samantha Lynn Wozniak | Physical Therapist | 3023 S. 84th St., Milwaukee, WI 53227 | 2013-02-27 |
| 1831434901 | Andrew Paul Roeder | Physical Therapy Assistant | 3023 S. 89th Street, Milwaukee, WI 53227 | 2012-11-30 |
| 1538418116 | Christine Wilford | Social Worker | 2044 S 96th Street, West Allis, WI 53227 | 2012-08-29 |
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| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710979984 | Kristin Cromwell Kim | Psychologist | 11101 W Lincoln Ave, Rogers Memorial Hospital, West Allis, WI 53227-1133 | 2005-08-16 |
| 1629167192 | Gary Major | Psychologist | 10229 W Greenfield Ave, West Allis, WI 53214-3911 | 2006-10-12 |
| 1841301066 | Mary C Bolton | Psychologist | 10201 W Lincoln Ave, 308, West Allis, WI 53227-2136 | 2006-08-31 |
| 1366552887 | Craig Alan Modell | Psychologist | 10229 W Greenfield Ave, West Allis, WI 53214 | 2006-08-30 |
| 1245223742 | Nancy Jean Goranson | Psychologist | 11101 W Lincoln Ave, Rogers Memorial Hospital, West Allis, WI 53227-1133 | 2005-08-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205445590 | Elizabeth Ann Mullen-houser | Psychologist | 1507 Winnebago St, La Crosse, WI 54601-4967 | 2020-07-23 |
| 1073138327 | Rachel Kahn | Psychologist | 501 Acacia Ln, Madison, WI 53716-3238 | 2020-06-12 |
| 1184248593 | Jill Mallin | Psychologist | 10 S Water St E, Fort Atkinson, WI 53538-2053 | 2020-06-01 |
| 1669095303 | Generational Cycles LLC | Psychologist | 2208 W Rohr Ave, Milwaukee, WI 53209-5057 | 2020-05-27 |
| 1518529718 | Ellen Marie Meier-licht | Psychologist | 200 N Mall Dr, Appleton, WI 54913-8500 | 2019-07-08 |
| 1396309076 | John Nathaniel Greene Jr. | Psychologist | 6100 N 42nd St, Milwaukee, WI 53209-3560 | 2019-04-27 |
| 1396201455 | Pathways Counseling Services | Psychologist | 1025 56th St, Kenosha, WI 53140-3737 | 2019-02-13 |
| 1912461385 | We All Rise Counseling Services LLC | Psychologist | 529 S Jefferson St Ste 201, Green Bay, WI 54301-4125 | 2019-01-30 |
| 1417426925 | Edward Dow | Psychologist | W268n1988 Shooting Star Road, Pewaukee, WI 53072 | 2018-11-14 |
| 1295202976 | Pkm Clinical Solutions LLC | Psychologist | W206s7867 Pasadena Dr, Muskego, WI 53150-9532 | 2018-10-31 |
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| City | WEST ALLIS |
| Zip Code | 53227 |
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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.