MARLENE A BANNEN (NPI# 1922002914) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922002914 |
| Entity Type | Individual |
| Full Name | MARLENE A BANNEN |
| Credential | PHD |
| Practice Address |
1836 South Ave La Crosse WI 54601-5429 |
| Practice Telephone | 6087827300 |
| Mailing Telephone | 6087827300 |
| Enumeration Date | 2005-06-08 |
| Last Update Date | 2010-07-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TB0200X |
Psychologist Specialization: Cognitive & Behavioral |
2317 | WI | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 39508100 | 05 |
| Street Address |
1836 SOUTH AVE |
| City | LA CROSSE |
| State | WI |
| Zip Code | 54601-5429 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952304834 | Susan G Maclellan-tobert | Pediatrics | 1836 South Ave, La Crosse, WI 54601-5429 | 2005-05-24 |
| 1861099590 | Ellen Compton | Dietitian, Registered | 1836 South Ave, La Crosse, WI 54601-5429 | 2020-10-06 |
| 1699382630 | Jedd Sebion | Pharmacist | 1836 South Ave, La Crosse, WI 54601-5429 | 2020-09-24 |
| 1104436351 | Taryn Jean Simon | Speech-Language Pathologist | 1836 South Ave, La Crosse, WI 54601-5429 | 2020-08-03 |
| 1497376438 | Eva Igler | Student in an Organized Health Care Education/Training Program | 1836 South Ave, La Crosse, WI 54601-5429 | 2020-04-30 |
| 1568083608 | Benjamin Haase Thompson | Student in an Organized Health Care Education/Training Program | 1836 South Ave, La Crosse, WI 54601-5429 | 2020-04-29 |
| 1316568736 | Eric Bobel | Student in an Organized Health Care Education/Training Program | 1836 South Ave, La Crosse, WI 54601-5429 | 2020-04-27 |
| 1134749708 | Kristin Danielle Heslep | Student in an Organized Health Care Education/Training Program | 1836 South Ave, La Crosse, WI 54601-5429 | 2020-04-23 |
| 1982224598 | Rebecca Stanek | Student in an Organized Health Care Education/Training Program | 1836 South Ave, La Crosse, WI 54601-5429 | 2020-04-23 |
| 1609496595 | Marie Gilberte Cineus | Student in an Organized Health Care Education/Training Program | 1836 South Ave, La Crosse, WI 54601-5429 | 2020-04-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891324265 | Meagan Mcrae | Student in an Organized Health Care Education/Training Program | 1725 State St., 4051 Health Science Center, La Crosse, WI 54601 | 2020-04-07 |
| 1255969671 | Erin Dingman | Student in an Organized Health Care Education/Training Program | 1751 State Street, 4051 Health Science Center, La Crosse, WI 54601 | 2020-03-31 |
| 1619505047 | Nicole Kay Lynch | Student in an Organized Health Care Education/Training Program | 4051 Health Science Center, 1725 State St, La Crosse, WI 54601 | 2020-03-31 |
| 1174151757 | Jenna Sells | Student in an Organized Health Care Education/Training Program | 4051 Health Science Center, 1725 State Street, La Crosse, WI 54601 | 2020-03-30 |
| 1740818301 | Katie Irene Tahtinen | Student in an Organized Health Care Education/Training Program | Uwl- 4051 Health Science Center, 1725 State St., La Crosse, WI 54601 | 2020-03-30 |
| 1932737517 | Margaret May Grimm | Student in an Organized Health Care Education/Training Program | Univesity of Wisconsin-la Crosse, 4051 Health Science Center, 1725 State Street, La Crosse, WI 54601 | 2020-03-30 |
| 1831727312 | Matthew Timothy Axler | Student in an Organized Health Care Education/Training Program | 4051 Health Science Center, 1725 State Street, La Crosse, WI 54601 | 2020-03-30 |
| 1093340473 | Denise Stinson | Technician | 1311 Badger St, Apt 505, La Crosse, WI 54601 | 2020-03-06 |
| 1922632397 | Ibrahim Ahsan | Pharmacist | 1105 Wi-16, La Crosse, WI 54601 | 2020-02-25 |
| 1750913356 | Liza R Collins | Massage Therapist | 1415 State Wi 16, La Crosse, WI 54601 | 2020-02-11 |
| Find all providers in zip 54601 | ||||
| Taxonomy Code | 103TB0200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Cognitive & Behavioral |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255693115 | Thomas Mark Ledoux | Psychologist | 1836 South Ave, La Crosse, WI 54601-5429 | 2012-06-15 |
| 1053317040 | Verne E Lewis | Psychologist | 1836 South Ave, La Crosse, WI 54601-5429 | 2005-06-23 |
| 1134125149 | Richard L Listiak | Psychologist | 1836 South Ave, La Crosse, WI 54601-5429 | 2005-06-23 |
| 1386648723 | Denyse G Olson-dorff | Psychologist | 1836 South Ave, La Crosse, WI 54601-5429 | 2005-06-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386109924 | Rebecca Timmins | Psychologist | 231 9th St, Menasha, WI 54952-2266 | 2019-02-07 |
| 1225368723 | Colleen A Ryan | Psychologist | N1563 County Road H, Palmyra, WI 53156-9738 | 2010-01-05 |
| 1548417389 | Nadia S Damm | Psychologist | 10855 W Potter Rd Ste 21, Wauwatosa, WI 53226-3439 | 2008-08-23 |
| 1720120959 | Advanced Psychological Innovations | Psychologist | 6418 Normandy Ln, Suite 215, Madison, WI 53719-1149 | 2007-02-13 |
| 1568573715 | Omne Clinic Inc | Psychologist | 233 E La Salle Avenue, Barron, WI 54812 | 2006-08-31 |
| 1619081437 | Omne Clinic, Inc. | Psychologist | 101 N. Farwell Street, Ste. 204, Eau Claire, WI 54703 | 2006-08-18 |
| 1548279045 | Dolores Kluppel Vetter | Psychologist | 6401 Odana Rd, Ste A, Madison, WI 53719-1126 | 2006-08-05 |
| 1316977192 | Tasha Farrar | Psychologist | 3301 N Ballard Rd Ste C, Appleton, WI 54911-9002 | 2006-07-04 |
| 1962462093 | John M O'donnell | Psychologist | 5225 N Ironwood Ln, Suite # 212, Glendale, WI 53217-4909 | 2006-03-24 |
| 1215913207 | Phyllis Kasper | Psychologist | 5300 Memorial Dr, Two Rivers, WI 54241-3923 | 2005-12-21 |
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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.