| Psychological Assessment Services, Llc | |
|
2380 N 124th St Ste 101 Wauwatosa WI 53226-1071 | |
| (414) 443-1773 | |
| (414) 443-1747 |
| Full Name | Psychological Assessment Services, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 2380 N 124th St Ste 101, Wauwatosa, Wisconsin |
| Authorized Official Name and Position | Karyn L Gust-brey (PARTNER/LICENSED PSYCHOLOGIST) |
| Authorized Official Contact | 4144431773 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Psychological Assessment Services, Llc 2380 N 124th St Ste 101 Wauwatosa WI 53226-1071 Ph: (414) 443-1773 | Psychological Assessment Services, Llc 2380 N 124th St Ste 101 Wauwatosa WI 53226-1071 Ph: (414) 443-1773 |
| NPI Number | 1275935033 |
|---|---|
| Provider Enumeration Date | 09/23/2014 |
| Last Update Date | 09/23/2014 |
| Medicare PECOS PAC ID | 3577815505 |
|---|---|
| Medicare Enrollment ID | O20181002003017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275935033 | NPI | - | NPPES |
| 1619072170 | Medicaid | WI | |
| 1861622524 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| Provider Name | Karyn L Gust-brey |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1861622524 PECOS PAC ID: 1153507389 Enrollment ID: I20110523000776 |
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