| Healthcare Psychology Consultants Llc | |
|
4447 N Oakland Ave Shorewood WI 53211 | |
| (414) 431-4322 | |
| (414) 431-4323 |
| Full Name | Healthcare Psychology Consultants Llc |
|---|---|
| Speciality | Psychologist |
| Location | 4447 N Oakland Ave, Shorewood, Wisconsin |
| Authorized Official Name and Position | Michael Luther Jorn (CLINICAL PSYCHOLOGIST SOLE OWNER) |
| Authorized Official Contact | 4144314322 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Healthcare Psychology Consultants Llc 1110 N Old World 3rd St Ste 410 Milwaukee WI 53203-1121 Ph: (414) 431-4322 | Healthcare Psychology Consultants Llc 4447 N Oakland Ave Shorewood WI 53211 Ph: (414) 431-4322 |
| NPI Number | 1063532380 |
|---|---|
| Provider Enumeration Date | 03/30/2007 |
| Last Update Date | 12/04/2014 |
| Medicare PECOS PAC ID | 7315906260 |
|---|---|
| Medicare Enrollment ID | O20041006000725 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063532380 | NPI | - | NPPES |
| 39113800 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 1912 (Wisconsin) | Primary |
| Provider Name | Michael L Jorn |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1073568697 PECOS PAC ID: 1850350703 Enrollment ID: I20041018000137 |
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