MELISSA A WINGATE (NPI# 1114456712) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114456712 |
| Entity Type | Individual |
| Full Name | MELISSA A WINGATE |
| Credential | PSYD |
| Practice Address |
10400 75th St Kenosha WI 53142-7884 |
| Practice Telephone | (262) 948-7815 |
| Practice Fax Number | 2629487816 |
| Mailing Telephone | 2629487815 |
| Mailing Fax Number | 2629487816 |
| Enumeration Date | 2017-06-07 |
| Last Update Date | 2017-09-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | 3474 | WI | Behavioral Health & Social Service Providers |
| N | 103TC0700X |
Psychologist Specialization: Clinical |
3474 | WI | Behavioral Health & Social Service Providers |
| Street Address |
10400 75TH ST |
| City | KENOSHA |
| State | WI |
| Zip Code | 53142-7884 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477546737 | Mea-aea Kenosha Sc | Family Medicine | 10400 75th St, Kenosha, WI 53142-7884 | 2005-08-23 |
| 1548877707 | Megan Labine | Dietitian, Registered | 10400 75th St, Kenosha, WI 53142-7884 | 2020-09-30 |
| 1730796574 | Saralyn Paredes | Nurse Practitioner | 10400 75th St, Kenosha, WI 53142-7884 | 2020-09-25 |
| 1518586965 | Ariel Adelsen | Registered Nurse | 10400 75th St, Kenosha, WI 53142-7884 | 2020-04-15 |
| 1134757073 | Amber Jirschele | Nurse Practitioner | 10400 75th St, Kenosha, WI 53142-8323 | 2020-03-27 |
| 1912539974 | Kristina A Roscizewski | Nurse Practitioner | 10400 75th St, Kenosha, WI 53142-7884 | 2020-02-07 |
| 1386274413 | Ethan Nathaniel Mcfaddin | Pharmacist | 10400 75th St, Kenosha, WI 53142-7884 | 2020-01-16 |
| 1972133031 | Patricia Grzyb | Physician Assistant | 10400 75th St, Kenosha, WI 53142-7884 | 2020-01-16 |
| 1144873654 | Lauren Cornejo | Occupational Therapist | 10400 75th St, Kenosha, WI 53142-8323 | 2019-07-23 |
| 1245710771 | Brenda Joyce Woodhull | Registered Nurse | 10400 75th St, Kenosha, WI 53142-7884 | 2018-08-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588297816 | Caring Hearts Home Health Care | In Home Supportive Care | 6021-57th Ave, Suite C103, Kenosha, WI 53142 | 2020-02-14 |
| 1144785395 | Michael L Wrzesinski | Counselor | 4109 67th Street, Kenosha, WI 53142 | 2019-02-01 |
| 1720538499 | David Smith | Counselor | 10900 67th Street, Kenosha, WI 53142 | 2016-10-06 |
| 1326404641 | Smile Doctors Ltd | Dentist | 7003 39th Ave, Kenosha, WI 53142 | 2016-01-04 |
| 1225409485 | Antonia Marie Decker | Physician Assistant | 10400 75th St. Ste 204, Kenosha, WI 53142 | 2015-10-14 |
| 1780060582 | Joshua Haas | Pharmacist | 7701 Green Bay Road, Kenosha, IL 53142 | 2015-08-04 |
| 1811379225 | Dana Mary Stout | Registered Nurse | 7401 104th Avenue, Suite 110, Comprehensive Orthopaedics, S.c., Kenosha, WI 53142 | 2015-06-22 |
| 1669815569 | Joshua Knute Elson | Radiology | 6811 118th Ave, Kenosha, WI 53142 | 2013-04-10 |
| 1356610166 | Michael J Gallo | Pharmacist | 7535 North Greenbay Rd, Kenosha, WI 53142 | 2011-12-22 |
| 1720357999 | Orest Carnevale | Registered Nurse | 7316 155th Ct, Kenosha, WI 53142 | 2011-12-18 |
| Find all providers in zip 53142 | ||||
| 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 |
|---|---|---|---|---|
| 1578023156 | Midway Clinical Neuropsychologic Institute and Children's Wellness Fou | Clinical Neuropsychologist | 1024 60th Street, Suite 5, Kenosha, WI 53140-4099 | 2019-03-21 |
| 1336319979 | Shellie Dee Locke | Clinical Neuropsychologist | 9020 15th Ave, Kenosha, WI 53143-6803 | 2008-03-11 |
| 1477515724 | Teresa Deer | Clinical Neuropsychologist | 5017 Green Bay Rd Ste 130, Kenosha, WI 53144-1782 | 2006-04-03 |
| 1912252198 | Tarra Anne Combs | Clinical Neuropsychologist | 12225 71st St, Kenosha, WI 53142 | 2012-07-13 |
| 1669799508 | June Restrepo | Clinical Neuropsychologist | 5017 Green Bay Rd Ste 130, Kenosha, WI 53144-1782 | 2010-05-03 |
| 1013059187 | Neuropsychological Consultants Inc | Clinical Neuropsychologist | 3601 30th Ave, Suite 102, Kenosha, WI 53144-1695 | 2007-02-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 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 |
| 1659598746 | Christopher Paul Wiebusch | Clinical Neuropsychologist | N27w23953 Paul Rd, Ste. 206, Pewaukee, WI 53072-6242 | 2007-04-19 |
| 1316008303 | Thomas Fisher | Clinical Neuropsychologist | 2419 S. Lenox Street, Milwaukee, WI 53207 | 2006-12-13 |
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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.