| Wisconsin Psychology Associates, Llc | |
|
318 Margaret Ct Burlington WI 53105-2330 | |
| (812) 201-3912 | |
| Not Available |
| Full Name | Wisconsin Psychology Associates, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 318 Margaret Ct, Burlington, Wisconsin |
| Authorized Official Name and Position | Rosita Fernandez (OWNER/PSYCHOLOGIST) |
| Authorized Official Contact | 8122013912 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wisconsin Psychology Associates, Llc 318 Margaret Ct Burlington WI 53105-2330 Ph: () - | Wisconsin Psychology Associates, Llc 318 Margaret Ct Burlington WI 53105-2330 Ph: (812) 201-3912 |
| NPI Number | 1639830151 |
|---|---|
| Provider Enumeration Date | 01/06/2022 |
| Last Update Date | 02/09/2022 |
| Certification Date | 02/09/2022 |
| Medicare PECOS PAC ID | 7012381536 |
|---|---|
| Medicare Enrollment ID | O20230324001279 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639830151 | NPI | - | NPPES |
| 300007198IN | Medicaid | IN | |
| 1376062851 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Secondary |
| 103TH0100X | Psychologist - Health Service | (* (Not Available)) | Primary |
| Provider Name | Rosita Fernandez |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1376062851 PECOS PAC ID: 7416221502 Enrollment ID: I20230324001341 |
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