MR. LARRY KEVIN HAMBERGER (NPI# 1780635524) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1780635524 |
Entity Type | Individual |
Full Name | MR. LARRY KEVIN HAMBERGER |
Other Name | MR. L KEVIN HAMBERGER |
Credential | PHD |
Practice Address |
2400 W Villard Ave Wfhc Glendale Family Center Milwaukee WI 53209-4901 |
Practice Telephone | 4145278458 |
Practice Fax Number | 4145278045 |
Mailing Telephone | 4145278458 |
Mailing Fax Number | 4145278045 |
Enumeration Date | 2006-05-15 |
Last Update Date | 2013-01-24 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
1004 | WI | Behavioral Health & Social Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
HUMANA | 002000119L | 01 | |
WI | 1780635524 | 05 |
Street Address |
2400 W VILLARD AVE WFHC GLENDALE FAMILY CENTER |
City | MILWAUKEE |
State | WI |
Zip Code | 53209-4901 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1205824786 | Joseph W Gravel Jr. | Family Medicine | 2400 W Villard Ave, Milwaukee, WI 53209-4901 | 2005-10-10 |
1053920504 | Jerry Varghese Thuthikattu John | Family Medicine | 2400 W Villard Ave, Milwaukee, WI 53209-4901 | 2020-07-29 |
1053929620 | Alyssa Nicole Fairservice | Student in an Organized Health Care Education/Training Program | 2400 W Villard Ave, Milwaukee, WI 53209-4901 | 2020-07-20 |
1427676113 | Wallis Olivia Edwards | Student in an Organized Health Care Education/Training Program | 2400 W Villard Ave, Milwaukee, WI 53209-4901 | 2020-07-08 |
1093334146 | Charles Franklin Mitchell IIi | Student in an Organized Health Care Education/Training Program | 2400 W Villard Ave, Milwaukee, WI 53209-4901 | 2020-04-09 |
1245869452 | Thomas William Kerndt | Student in an Organized Health Care Education/Training Program | 2400 W Villard Ave, Milwaukee, WI 53209-4901 | 2020-04-08 |
1508494121 | Yelena Planic | Student in an Organized Health Care Education/Training Program | 2400 W Villard Ave, Milwaukee, WI 53209-4901 | 2020-03-30 |
1184276792 | Thomas Allen Puffett | Family Medicine | 2400 W Villard Ave, Milwaukee, WI 53209-4901 | 2019-07-13 |
1093377335 | Maggie Elizabeth Walsh | Student in an Organized Health Care Education/Training Program | 2400 W Villard Ave, Milwaukee, WI 53209-4901 | 2019-07-08 |
1093377434 | Jayasakthi Palaniappan | Student in an Organized Health Care Education/Training Program | 2400 W Villard Ave, Milwaukee, WI 53209-4901 | 2019-07-06 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1780238253 | Niajcia Brookshire | Counselor | 3900 W Brown Deer Rd Suite 200, Brown Deer, WI 53209 | 2019-08-01 |
1740751015 | Mary Fuller | Home Health Aide | 3043 N 29th St., Milwaukee, WI 53209 | 2018-12-16 |
1154869410 | Jacksonscott2 | Skilled Nursing Facility | 4573 N. 22nd Street, Milwaukee, WI 53209 | 2017-02-07 |
1669910469 | Dimera House | In Home Supportive Care | 4002 W Fairount Ave, Milwaukee, WI 53209 | 2017-02-01 |
1891248340 | Amy L May | Nurse Practitioner | 3303 W Good Hope Rd, Milwaukee, WI 53209 | 2016-08-02 |
1871980193 | Alan R Rosenthal | Pharmacist | 6930 N Beech Tree Dr, Milwaukee, WI 53209 | 2015-04-24 |
1104212380 | Reema Shah | Student in an Organized Health Care Education/Training Program | 2400 W. Villard Ave, Milwaukee, WI 53209 | 2015-04-14 |
1336534403 | Robert Michael Kitsis | Family Medicine | 9252 N Green Bay Rd Fl 2, Brown Deer, WI 53209 | 2015-04-05 |
1962891994 | Kls Community Outreach Teen Center Consulting and Management L.L.C. | Public Health or Welfare | 8330 North Teutonia Ave Suite 103, Brown Deer, WI 53209 | 2015-01-14 |
1548659634 | Kls Community Outreach Teen Center Consulting and Management L.L.C. | Early Intervention Provider Agency | 8330 North Teutonia Avenue Suite 103, Brown Deer, WI 53209 | 2015-01-13 |
Find all providers in zip 53209 |
Taxonomy Code | 103TC2200X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Psychologist |
Specialization | Clinical Child & Adolescent |
Definition to come... |
Notes: [1/1/2007: title modified] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1376068379 | Monica L Gremillion | Psychologist | 9000 W Wisconsin Ave # Ms 958, Milwaukee, WI 53226-4874 | 2017-08-10 |
1861808412 | Jeffrey Karst | Psychologist | 8701 Watertown Plank Rd., Mfrc 3018, Medical College of Wisconsin Pediatric Hem/onc/bmt, Milwaukee, WI 53226 | 2014-07-03 |
1194008250 | Jenny Cvinar Walczak | Psychologist | 9000 W Wisconsin Ave, Milwaukee, WI 53226-4874 | 2011-09-26 |
1437315280 | Sheri L. Johnson | Psychologist | 5433 W Fond Du Lac Ave, Midtown Pediatrics, Milwaukee, WI 53216-1382 | 2008-07-31 |
1518129089 | Kristin H Kroll | Psychologist | 9000 W Wisconsin Ave, Milwaukee, WI 53226-4874 | 2008-06-26 |
1710151246 | Isabela Sardas | Psychologist | 930 W Historic Mitchell St, Milwaukee, WI 53204-3533 | 2008-04-16 |
1275657272 | Angela C Stanley | Psychologist | 9000 W Wisconsin Ave, Milwaukee, WI 53226-4874 | 2007-03-17 |
1134173776 | Cheryl L Brosig Soto | Psychologist | 9000 W Wisconsin Ave, Children's Health Sys Office Bldg, Milwaukee, WI 53226-3518 | 2006-05-19 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1265634505 | Kimberly Arlene Young | Psychologist | 3505 N 124th St, Uppr, Brookfield, WI 53005-2489 | 2007-05-31 |
1073683413 | Amy M Schley | Psychologist | 204 Wisconsin Ave, Waukesha, WI 53186-4927 | 2006-11-09 |
1740229079 | Mary Margaret Rhoades | Psychologist | 5 Odana Ct, Madison, WI 53719-1120 | 2006-06-05 |
1861458093 | Anton C Smets | Psychologist | 101 N Farwell St Ste 204, Eau Claire, WI 54703-3767 | 2006-04-25 |
1265408173 | Marianne B Burton | Psychologist | 3610 Michelle Witmer Memorial Dr., New Berlin, WI 53151 | 2006-02-28 |
1003398868 | Megan Kay Higinbotham | Psychologist | 430 E Division St, Fond Du Lac, WI 54935-4597 | 2018-08-29 |
1134645724 | Kelsie-marie Offenwanger | Psychologist | 1000 N Oak Ave, Marshfield, WI 54449-5703 | 2017-08-16 |
1699155648 | Center for Language Acquisition and Social Skills Intervention, LLC | Psychologist | 8239 W Hillview Dr, Mequon, WI 53097-3205 | 2015-06-04 |
1932501053 | Christopher Waser | Psychologist | 1524 S Lee St, Appleton, WI 54915-3822 | 2014-09-19 |
1821338815 | Susan M. Oestreicher | Psychologist | 444 N Westhill Blvd, Appleton, WI 54914-5715 | 2013-02-27 |
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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.