MARY LYNNE MACK (NPI# 1700811015) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700811015 |
| Entity Type | Individual |
| Full Name | MARY LYNNE MACK |
| Credential | PHD |
| Practice Address |
20700 Watertown Rd Ste 240 Waukesha WI 53186-1800 |
| Mailing Address |
N19w26738 Milkweed Ln Unit A Pewaukee WI 53072-5657 |
| Practice Telephone | 2623912551 |
| Practice Fax Number | 2622641060 |
| Mailing Telephone | 2623912551 |
| Mailing Fax Number | 2622641060 |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2019-11-15 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | 2598-057 | WI | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 40916300 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487947677 | Mary Lynn Mack | Social Worker | 420 Washington Ave, Cuyahoga Falls, OH 44221-2039 | 2011-05-19 |
| 1104930700 | Mary Louise Mack | Counselor | 2633 West Blvd, Charlotte, NC 28208-6705 | 2006-08-19 |
| 1962023598 | Mary Mack | Nurse Practitioner | 3805 San Dimas St Ste B, Bakersfield, CA 93301-5725 | 2020-05-05 |
| 1548824238 | Mary Mack | Social Worker | 525 W Brown Rd, Mesa, AZ 85201-3202 | 2019-04-28 |
| 1851682181 | Mary Colleen Mack | Counselor | 151 N Main St, Decatur, IL 62523-1206 | 2011-04-20 |
| 1639349475 | Mary Lillian Mack | Registered Nurse | 121 S Dixie Ave, Cookeville, TN 38501-3401 | 2008-03-07 |
| Street Address |
20700 WATERTOWN RD STE 240 |
| City | WAUKESHA |
| State | WI |
| Zip Code | 53186-1800 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639415078 | Mary Lynne Mack Phd LLC | Psychologist | 20700 Watertown Rd Ste 240, Waukesha, WI 53186-1800 | 2012-12-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295391472 | Christine Lowdon Triggs | Dentist | 21680 West Bluemound Rd, Waukesha, WI 53186 | 2019-05-14 |
| 1881182889 | Allure Medical of Wisconsin Pllc | Clinic/Center | 1930 W Bluemound Rd Ste 340, Waukesha, WI 53186 | 2018-04-25 |
| 1316462104 | Mary B Mckee | Dietitian, Registered | 22370 W Bluemound Rd, #102, Waukesha, WI 53186 | 2017-08-14 |
| 1740738343 | Rebecca Menelle | Physical Therapist | 1809 Shepherd Ct, Apt 206, Waukesha, WI 53186 | 2016-09-13 |
| 1568919876 | Dianne Isnard | Physical Therapist | W231n1440 Corporate Court, Waukesha, WI 53186 | 2016-09-02 |
| 1982065991 | Brandon James Decker | Nurse Practitioner | 21775 Hillcrest Drive, Waukesha, WI 53186 | 2016-03-18 |
| 1598142937 | Sophia Marie Klingbiel | Social Worker | 1515 Paramount Dr., Waukesha, WI 53186 | 2015-05-06 |
| 1326478165 | Glen D Haberman | Dentist | 141 Wisconsin Avenue, Waukesha, WI 53186 | 2013-11-14 |
| 1487991014 | Sara Nicole Francis | Counselor | 217 Wisconsin Ave Ste 211, Waukesha, WI 53186 | 2013-01-16 |
| 1770862054 | Alex Colque, M.d. S.c. | Plastic Surgery | 21675 E Moreland Blvd, Suite 100, Waukesha, WI 53186 | 2011-08-04 |
| Find all providers in zip 53186 | ||||
| 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 |
|---|---|---|---|---|
| 1316023377 | Efficiency Management Consulting | Psychologist | 20860 Watertown Rd, Waukesha, WI 53186-1872 | 2006-10-31 |
| 1922194737 | Terrill Lewis Bruett | Psychologist | 2717 Grandview Blvd Suite 303, Waukesha, WI 53188 | 2006-10-05 |
| 1013929108 | David Lee Smith | Psychologist | 407 Pilot Ct, Suite #400, Waukesha, WI 53188-2498 | 2006-08-13 |
| 1669480059 | Jane Marie Schneider | Psychologist | 741 N Grand Ave Ste 302, Waukesha, WI 53186-4820 | 2006-08-03 |
| 1407875230 | Jay Allen | Psychologist | 2314 N Grandview Blvd, Suites 301 and 110, Waukesha, WI 53188-1675 | 2006-07-19 |
| 1447223045 | Timothy E. Tyre | Psychologist | Waukesha Memorial Hospital-neuroscience Center, 725 American Avenue, Waukesha, WI 53188 | 2006-02-13 |
| 1902358120 | Laurie Donnell Bjustrom | Psychologist | 741 N Grand Ave Ste 302, Waukesha, WI 53186-4841 | 2016-11-04 |
| 1710226691 | Bridget Elizabeth Kanz | Psychologist | 514 Riverview Ave, Waukesha, WI 53188-3631 | 2013-02-12 |
| 1649588872 | David Radovich | Psychologist | W231n1440 Corporate Ct Ste 310, Waukesha, WI 53186-1303 | 2010-09-22 |
| 1033341953 | Sheila Marie Gissibl | Psychologist | 2607 N Grandview Blvd, Suite 108, Waukesha, WI 53188-1686 | 2009-08-11 |
| Find all providers in WAUKESHA | ||||
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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.