| Jeffrey Ligman, Psy.d.s.c. | |
|
10045 W Lisbon Ave Ste 250 Wauwatosa WI 53222-2446 | |
| (414) 460-7500 | |
| Not Available |
| Full Name | Jeffrey Ligman, Psy.d.s.c. |
|---|---|
| Speciality | Psychologist |
| Location | 10045 W Lisbon Ave Ste 250, Wauwatosa, Wisconsin |
| Authorized Official Name and Position | Jeffrey D. Ligman (PRESIDENT) |
| Authorized Official Contact | 4144607500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jeffrey Ligman, Psy.d.s.c. 10045 W Lisbon Ave Ste 250 Wauwatosa WI 53222-2446 Ph: (414) 460-7500 | Jeffrey Ligman, Psy.d.s.c. 10045 W Lisbon Ave Ste 250 Wauwatosa WI 53222-2446 Ph: (414) 460-7500 |
| NPI Number | 1003593062 |
|---|---|
| Provider Enumeration Date | 06/30/2023 |
| Last Update Date | 02/01/2024 |
| Certification Date | 02/01/2024 |
| Medicare PECOS PAC ID | 1355702713 |
|---|---|
| Medicare Enrollment ID | O20230801002931 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003593062 | NPI | - | NPPES |
| 1281-057 | Other | WI | PSYCHOLOGIST LICENSE |
| 39090200 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| Provider Name | Jeffrey D Ligman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1538148812 PECOS PAC ID: 6305898131 Enrollment ID: I20081208000128 |
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