| Jmd, Psychology, Llc | |
|
14135 N Cedarburg Rd Mequon WI 53097-1416 | |
| (262) 261-3023 | |
| (262) 377-5552 |
| Full Name | Jmd, Psychology, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 14135 N Cedarburg Rd, Mequon, Wisconsin |
| Authorized Official Name and Position | Joshua Dolan (LICENSED PSYCHOLOGIST) |
| Authorized Official Contact | 2622613023 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jmd, Psychology, Llc 2071 Upper Ridge Rd Port Washington WI 53074-9660 Ph: (262) 261-3023 | Jmd, Psychology, Llc 14135 N Cedarburg Rd Mequon WI 53097-1416 Ph: (262) 261-3023 |
| NPI Number | 1013516905 |
|---|---|
| Provider Enumeration Date | 10/21/2020 |
| Last Update Date | 10/21/2020 |
| Certification Date | 10/21/2020 |
| Medicare PECOS PAC ID | 8426460460 |
|---|---|
| Medicare Enrollment ID | O20201215002143 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013516905 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC1900X | Psychologist - Counseling | (* (Not Available)) | Primary |
| Provider Name | Joshua Dolan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1639508823 PECOS PAC ID: 1850604190 Enrollment ID: I20150716000358 |
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