HEALTHY MINDS OF THE FOX VALLEY LLC (NPI# 1518346261) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1518346261 |
Entity Type | Organization |
Organization Name | HEALTHY MINDS OF THE FOX VALLEY LLC |
Practice Address |
1045 N Lynndale Dr Ste 1c Appleton WI 54914-3048 |
Mailing Address |
6188 Clarks Rd Winneconne WI 54986-9760 |
Practice Telephone | 9025510013 |
Mailing Telephone | 9085510013 |
Enumeration Date | 2015-05-28 |
Last Update Date | 2015-06-10 |
Authorized Official Name | TAMMY LEE HIETPAS (OWNER) |
Authorized Official Telephone | 7159378819 |
Authorized Official Credential | PHD |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 103G00000X | Clinical Neuropsychologist | 72200-1519 | WI | Behavioral Health & Social Service Providers |
Street Address |
1045 N LYNNDALE DR STE 1C |
City | APPLETON |
State | WI |
Zip Code | 54914-3048 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1770612426 | All About You Medical Supplies LLC | Durable Medical Equipment & Medical Supplies | 1045 N Lynndale Dr, Ste 1b, Appleton, WI 54914-3048 | 2007-03-05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1518572429 | Claire Schuh | Social Worker | 3416 Association Ln, Appleton, WI 54914 | 2020-09-09 |
1568099729 | Access Elevator, Inc. | Contractor | 1314 W. College Ave, Appleton, WI 54914 | 2020-03-26 |
1124677885 | Sharon Darla Cornell | Technician | 3117 N. Mistwood Lane, Appleton, WI 54914 | 2019-09-05 |
1235647793 | Midwest Monitoring, LLC | Psychiatry & Neurology | 4321 W College Ave Ste 200, Appleton, WI 54914 | 2018-01-18 |
1356863252 | Uvanta Pharmacy LLC | Pharmacy | 1050 S Grider St, Suite C, Appleton, WI 54914 | 2017-07-12 |
1255860912 | Appleton Counseling Management LLC | Counselor | 477 S Nicolet Rd., Appleton, WI 54914 | 2017-06-07 |
1609269489 | Shane Scott Urban | Social Worker | 444 N. Westhill Blvd., Appleton, WI 54914 | 2015-03-18 |
1699184580 | Michelle Becker | Nurse Practitioner | 4435 West Lawrence St., Appleton, WI 54914 | 2014-08-05 |
1972857514 | Jean Flesch | Pharmacist | 1000 W. Northland Ave., Appleton, WI 54914 | 2012-11-05 |
1477845147 | Mallory Barbara Herrin | Counselor | 820 W. College Ave, Appleton, WI 54914 | 2011-05-12 |
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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 |
---|---|---|---|---|
1396170965 | Jillian M Schuh | Clinical Neuropsychologist | 444 N Westhill Blvd, Appleton, WI 54914-5715 | 2013-09-13 |
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 |
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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.