ELEANOR ARLENE TIDBALL (NPI# 1629607619) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629607619 |
| Entity Type | Individual |
| Full Name | ELEANOR ARLENE TIDBALL |
| Credential | LPC-IT |
| Practice Address |
13320 W Grange Ave New Berlin WI 53151-8131 |
| Practice Telephone | 4144673780 |
| Mailing Telephone | 4144673780 |
| Enumeration Date | 2020-04-02 |
| Last Update Date | 2020-04-02 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC1900X |
Psychologist Specialization: Counseling |
4590-226 | WI | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 19943852 | 05 |
| Street Address |
13320 W GRANGE AVE |
| City | NEW BERLIN |
| State | WI |
| Zip Code | 53151-8131 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629527486 | Natural Look Salon and Wigs LLC | Durable Medical Equipment & Medical Supplies | 4805 S. Moorland Rd, New Berlin, WI 53151 | 2016-09-22 |
| 1396193033 | New Berlin Medical Services, LLC | Clinic/Center | 15324 W Beloit Road, New Berlin, WI 53151 | 2016-06-02 |
| 1063899680 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 15300 West Grange Avenue, New Berlin, WI 53151 | 2015-05-04 |
| 1871970368 | Mary Spath | Physical Therapy Assistant | 2810 South Acredale Road, New Berlin, WI 53151 | 2015-05-04 |
| 1669885471 | Wauwatosa Prescription Center, Inc. | Pharmacy | 4855 S Moorland Road, New Berlin, WI 53151 | 2014-06-09 |
| 1750711446 | Pure Family Chiropractic LLC | Chiropractor | 3504 S. Moorland Road, New Berlin, WI 53151 | 2013-11-18 |
| 1336578202 | Hamilton John Dowden | Chiropractor | 3504 S Moorland Rd, New Berlin, WI 53151 | 2013-11-01 |
| 1053653618 | Danielle Lynn Lucio | Acupuncturist | 15807 W. National Ave., New Berlin, WI 53151 | 2013-03-21 |
| 1306195110 | Marlena J Friedrich | Registered Nurse | 1709 S. 171st Street, New Berlin, WI 53151 | 2012-09-07 |
| 1548519176 | Patricia M Friedrich | Licensed Practical Nurse | 1709 So. 171st Street, New Berlin, WI 53151 | 2012-08-29 |
| Find all providers in zip 53151 | ||||
| Taxonomy Code | 103TC1900X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Counseling |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134769441 | Graham Gardner Knowlton | Psychologist | Milwaukee Vamc 5000 W National Ave, Milwaukee, WI 53295-0001 | 2020-01-14 |
| 1477197929 | Samuel David Lustgarten | Psychologist | 1025 W Johnson St Rm 303b, Madison, WI 53706-1706 | 2019-10-28 |
| 1467095703 | Ifrah Hameed | Psychologist | 1849 N Doctor M.l.k. Jr Dr# 101, Milwaukee, WI 53212 | 2019-10-18 |
| 1770133555 | Kerrin Sendrowitz O'connor | Psychologist | 1509 S Outagamie St, Appleton, WI 54914-5580 | 2019-09-13 |
| 1982193546 | Samantha Jo Schwartz-oscar | Psychologist | 2809 School Rd, Greenleaf, WI 54126-9209 | 2018-05-08 |
| 1790202851 | Wisconsin Lutheran Child & Family Service | Psychologist | 2669 N Richards St, Milwaukee, WI 53212-2850 | 2017-08-29 |
| 1902337785 | Carla Mae Davey | Psychologist | 333 E Campus Mall Rm 7, University Health Services, Madison, WI 53715-1740 | 2017-03-23 |
| 1558739300 | Hayley Shilling | Psychologist | 6602 Grand Teton Plz Ste 100, Madison, WI 53719-2905 | 2015-09-10 |
| 1568850840 | Belinda Gutierrez | Psychologist | 2500 Overlook Terrace, 116b, William S. Middleton Memorial Veterans Hospital, Madison, WI 53705-2286 | 2015-01-08 |
| 1700281912 | Joe Warren Hatcher | Psychologist | 960 Thomas St, Ripon, WI 54971-1804 | 2014-10-30 |
| Find all providers with the same taxonomy | ||||
| City | NEW BERLIN |
| Zip Code | 53151 |
Please comment or provide details below to improve the information on ELEANOR ARLENE TIDBALL.
| 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.