DR. JACQUELYN BOGDANOV (NPI# 1194230599) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1194230599 |
Entity Type | Individual |
Full Name | DR. JACQUELYN BOGDANOV |
Credential | PSYD |
Practice Address |
16535 W Bluemound Rd Ste 200 Brookfield WI 53005-5906 |
Practice Telephone | 2627891191 |
Mailing Telephone | 2627891191 |
Enumeration Date | 2017-12-06 |
Last Update Date | 2019-02-26 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 103TC0700X |
Psychologist Specialization: Clinical |
3661-57 | WI | Behavioral Health & Social Service Providers |
N | 103TC1900X |
Psychologist Specialization: Counseling |
6743-125 | WI | Behavioral Health & Social Service Providers |
Street Address |
16535 W BLUEMOUND RD STE 200 |
City | BROOKFIELD |
State | WI |
Zip Code | 53005-5906 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1477513588 | Jessica Joan Suhr | Social Worker | 16535 W Bluemound Rd Ste 200, Brookfield, WI 53005-5906 | 2006-03-23 |
1538729850 | Noelle Giannini | Counselor | 16535 W Bluemound Rd Ste 200, Brookfield, WI 53005-5906 | 2019-06-18 |
1770055170 | Heather Mae Klemm | Counselor | 16535 W Bluemound Rd Ste 200, Brookfield, WI 53005-5906 | 2018-12-23 |
1114463080 | Sarah Jean Mcdowell | Counselor | 16535 W Bluemound Rd Ste 200, Brookfield, WI 53005-5906 | 2017-01-16 |
1013398726 | Nicole Szaniawski | Dietitian, Registered | 16535 W Bluemound Rd Ste 200, Brookfield, WI 53005-5906 | 2015-06-18 |
1922376839 | David S Swoboda | Counselor | 16535 W Bluemound Rd Ste 200, Brookfield, WI 53005-5906 | 2011-12-06 |
1093017196 | Michael J. Logan Md, Sc | Clinic/Center | 16535 W Bluemound Rd Ste 200, Brookfield, WI 53005-5906 | 2010-11-22 |
1700097045 | Michelle Kathleen Vanden Noven | Psychiatry & Neurology | 16535 W Bluemound Rd Ste 200, Brookfield, WI 53005-5906 | 2007-05-25 |
1760508113 | Laura E Gray | Counselor | 16535 W Bluemound Rd Ste 200, Brookfield, WI 53005-5906 | 2007-03-21 |
1184788465 | Dennis Patrick Frank | Counselor | 16535 W Bluemound Rd Ste 200, Brookfield, WI 53005-5906 | 2006-12-20 |
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 | 103TC0700X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Psychologist |
Specialization | Clinical |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1942660600 | Allison Sidel | Psychologist | 304 Federal Rd Ste 301, Brookfield, CT 06804-2423 | 2016-02-24 |
1568784114 | Rebecca Lynn Thompson | Psychologist | 150 N Sunny Slope Rd, Suite #100, Brookfield, WI 53005-4806 | 2010-02-24 |
1861602609 | Douglas Eugene Scarth | Psychologist | 2 Old New Milford Rd Ste 1e, Brookfield, CT 06804-2426 | 2007-05-23 |
1932255833 | Henry Barron | Psychologist | 2224 Twin Pond Rd, Brookfield, VT 05036-9540 | 2007-01-25 |
1669537015 | Lynne Berendsen | Psychologist | 13035 W Bluemound Rd, Suite 100, Brookfield, WI 53005-8001 | 2006-12-26 |
1356401475 | Howard Joel Haven | Psychologist | 12690 W North Avenue, Elmbrook Family Counseling Center, Brookfield, WI 53005 | 2006-12-11 |
1922172634 | Judy A Eager | Psychologist | 13965 W Burleigh Rd, Suite 203, Brookfield, WI 53005-3064 | 2006-11-17 |
1649361775 | Kim Marie Gorecki | Psychologist | 19275 W Capitol Dr Ste 200, Brookfield, WI 53045-2734 | 2006-09-27 |
1427002211 | Eric D Seybold | Psychologist | 12690 W North Ave, Brookfield, WI 53005-4636 | 2006-05-19 |
1902344765 | Debra Hultquist | Psychologist | 150 N Sunny Slope Rd Ste 100, Brookfield, WI 53005 | 2017-02-01 |
Find all providers in BROOKFIELD |
City | BROOKFIELD |
Zip Code | 53005 |
Please comment or provide details below to improve the information on DR. JACQUELYN BOGDANOV.
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.