DR. TIFFANY M JACOBSEN (NPI# 1821360199) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821360199 |
| Entity Type | Individual |
| Full Name | DR. TIFFANY M JACOBSEN |
| Credential | PSYD |
| Practice Address |
2448 S 102nd St Ste 270 Milwaukee WI 53227-2147 |
| Practice Telephone | 4148007645 |
| Practice Fax Number | 4148007647 |
| Mailing Telephone | 4148007645 |
| Mailing Fax Number | 4148007647 |
| Enumeration Date | 2012-02-02 |
| Last Update Date | 2020-02-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103G00000X | Clinical Neuropsychologist | 3720-57 | WI | Behavioral Health & Social Service Providers |
| Y | 103T00000X | Psychologist | 3720-57 | WI | Behavioral Health & Social Service Providers |
| Street Address |
2448 S 102ND ST STE 270 |
| City | MILWAUKEE |
| State | WI |
| Zip Code | 53227-2147 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205451564 | Ginger Renee Bland | Nurse Practitioner | 11133 W. National Avenue, West Allis, WI 53227 | 2020-06-12 |
| 1003312141 | Dynamic Medical Equipment, LLC | Durable Medical Equipment & Medical Supplies | 10236 W National Ave, West Allis, WI 53227 | 2018-04-05 |
| 1932572641 | Alissa Kristine Walker | Specialist/Technologist | 11601 W Lincoln Ave, West Allis, WI 53227 | 2015-11-03 |
| 1396155990 | Bradly Earl Helinski | Physical Therapy Assistant | 3023 S 84th St., Milwaukee, WI 53227 | 2014-05-05 |
| 1609299783 | Amy Renee Rozumalski | Occupational Therapy Assistant | 10150 W. National Ave, Suite 150, Premiere Medical Staffing Services, LLC, Milwaukee, WI 53227 | 2014-01-27 |
| 1497098438 | Kathleen Marie Schneider | Physical Therapy Assistant | 3023 S. 84th Street, Milwaukee, WI 53227 | 2013-03-28 |
| 1760723373 | Lee Ann Schraith | Physical Therapy Assistant | 3023 S. 84th St, Milwaukee, WI 53227 | 2013-03-06 |
| 1740520725 | Samantha Lynn Wozniak | Physical Therapist | 3023 S. 84th St., Milwaukee, WI 53227 | 2013-02-27 |
| 1831434901 | Andrew Paul Roeder | Physical Therapy Assistant | 3023 S. 89th Street, Milwaukee, WI 53227 | 2012-11-30 |
| 1538418116 | Christine Wilford | Social Worker | 2044 S 96th Street, West Allis, WI 53227 | 2012-08-29 |
| Find all providers in zip 53227 | ||||
| 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 |
|---|---|---|---|---|
| 1669095303 | Generational Cycles LLC | Psychologist | 2208 W Rohr Ave, Milwaukee, WI 53209-5057 | 2020-05-27 |
| 1396309076 | John Nathaniel Greene Jr. | Psychologist | 6100 N 42nd St, Milwaukee, WI 53209-3560 | 2019-04-27 |
| 1851889901 | Elliot L Broch | Psychologist | 3266 N 53rd St, Milwaukee, WI 53216-3248 | 2018-04-24 |
| 1457858573 | Nina Sathasivam-rueckert | Psychologist | Zablocki Va Medical Center 5000 West National Avenue, Milwaukee, WI 53295 | 2018-04-06 |
| 1043730864 | Venice Anderson | Psychologist | 5000 W National Ave Bldg 109, Milwaukee, WI 53295-0001 | 2017-06-22 |
| 1306230057 | Henry Boeh | Psychologist | 250 N. Sunnyslope Road, Suite 203, Milwaukee, WI 53213-3574 | 2015-03-19 |
| 1851794382 | Dr. Robert A Gruenberg | Psychologist | 6213 N Green Bay Ave., Milwaukee, WI 53209-3823 | 2014-09-29 |
| 1538590393 | Psychological Purposes LLC | Psychologist | 3229 S Adams Ave, Milwaukee, WI 53207-2705 | 2013-12-04 |
| 1568890150 | David Phelps | Psychologist | 401 E Kilbourn Ave, Suite 402, Milwaukee, WI 53202-3212 | 2013-10-17 |
| 1366788994 | Christina Mh Engn | Psychologist | 740 N Plankinton Ave Ste 334, Milwaukee, WI 53203-2403 | 2012-12-31 |
| Find all providers in MILWAUKEE | ||||
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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.