TARRA ANNE COMBS


Address: 12225 71st St, Kenosha, WI 53142
Phone: 8776667223

TARRA ANNE COMBS (NPI# 1912252198) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1912252198
Entity Type Individual
Full Name TARRA ANNE COMBS
Practice Address 12225 71st St
Kenosha
WI 53142
Mailing Address 12225 71st St
Kenosha
WI 53142-7320
Practice Telephone 8776667223
Mailing Telephone 8776667223
Enumeration Date 2012-07-13
Last Update Date 2019-10-07
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103G00000X Clinical Neuropsychologist 3685-57 WI Behavioral Health & Social Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
WI 100093331 05

Provider Secondary Practice Location

Address Telephone Number Fax Number
3010 Grand Ave, Waukegan, IL 600852321 5707640193

Office Location

Street Address 12225 71ST ST
City KENOSHA
State WI
Zip Code 53142

Providers in the same location

NPI Name Taxonomy Address Enumeration
1376720359 Katherine M Flynn Psychologist 12225 71st St, Kenosha, WI 53142-7320 2008-01-22
1679963706 Jill R Lotz Nurse Practitioner 12225 71st St, Kenosha, WI 53142-7320 2015-01-27
1023354214 Adam M Stoll Social Worker 12225 71st St, Kenosha, WI 53142-7320 2012-12-17
1801152673 Juvaria Shahabuddin Psychiatry & Neurology 12225 71st St, Kenosha, WI 53142-7320 2012-04-05
1558642629 Rebecca Bons Psychologist 12225 71st St, Kenosha, WI 53142-7320 2011-09-02
1912206384 Jawad Pervez Psychiatry & Neurology 12225 71st St, Kenosha, WI 53142-7320 2011-03-24
1770812984 Peggy A Horon Counselor 12225 71st St, Kenosha, WI 53142-7320 2009-12-17

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1588297816 Caring Hearts Home Health Care In Home Supportive Care 6021-57th Ave, Suite C103, Kenosha, WI 53142 2020-02-14
1144785395 Michael L Wrzesinski Counselor 4109 67th Street, Kenosha, WI 53142 2019-02-01
1720538499 David Smith Counselor 10900 67th Street, Kenosha, WI 53142 2016-10-06
1326404641 Smile Doctors Ltd Dentist 7003 39th Ave, Kenosha, WI 53142 2016-01-04
1225409485 Antonia Marie Decker Physician Assistant 10400 75th St. Ste 204, Kenosha, WI 53142 2015-10-14
1780060582 Joshua Haas Pharmacist 7701 Green Bay Road, Kenosha, IL 53142 2015-08-04
1811379225 Dana Mary Stout Registered Nurse 7401 104th Avenue, Suite 110, Comprehensive Orthopaedics, S.c., Kenosha, WI 53142 2015-06-22
1669815569 Joshua Knute Elson Radiology 6811 118th Ave, Kenosha, WI 53142 2013-04-10
1356610166 Michael J Gallo Pharmacist 7535 North Greenbay Rd, Kenosha, WI 53142 2011-12-22
1720357999 Orest Carnevale Registered Nurse 7316 155th Ct, Kenosha, WI 53142 2011-12-18
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Taxonomy Information

Taxonomy Code 103G00000X
Grouping Behavioral Health & Social Service Providers
Classification Clinical Neuropsychologist

Taxonomy Definition

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]

Providers in the same taxonomy and city

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
1336319979 Shellie Dee Locke Clinical Neuropsychologist 9020 15th Ave, Kenosha, WI 53143-6803 2008-03-11
1477515724 Teresa Deer Clinical Neuropsychologist 5017 Green Bay Rd Ste 130, Kenosha, WI 53144-1782 2006-04-03
1114456712 Melissa A Wingate Clinical Neuropsychologist 10400 75th St, Kenosha, WI 53142-7884 2017-06-07
1669799508 June Restrepo Clinical Neuropsychologist 5017 Green Bay Rd Ste 130, Kenosha, WI 53144-1782 2010-05-03
1013059187 Neuropsychological Consultants Inc Clinical Neuropsychologist 3601 30th Ave, Suite 102, Kenosha, WI 53144-1695 2007-02-13

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
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
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
1659598746 Christopher Paul Wiebusch Clinical Neuropsychologist N27w23953 Paul Rd, Ste. 206, Pewaukee, WI 53072-6242 2007-04-19
1316008303 Thomas Fisher Clinical Neuropsychologist 2419 S. Lenox Street, Milwaukee, WI 53207 2006-12-13
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Competitor

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City KENOSHA
Zip Code 53142

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Dataset Information

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.

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