Dr Kenneth R Pride, PHD is a
Psychologist - Clinical based in Ashwaubenon, Wisconsin. Dr Kenneth R Pride is licensed to practice in Wisconsin (license number 1583-057) and his current practice location is
2129 So. Oneida, Ste: 113, Ashwaubenon, Wisconsin. He can be reached at his office (for appointments etc.) via phone at
(920) 429-0159.
NPI number for Dr Kenneth R Pride is 1336221373 and his current mailing address is 2129 So. Oneida, Ste: 113, Ashwaubenon, Wisconsin. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1336221373.
Healthcare Provider's Profile
Full Name | Dr Kenneth R Pride |
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Gender | Male |
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Speciality | Psychologist - Clinical |
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Location | 2129 So. Oneida, Ashwaubenon, Wisconsin |
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Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
NPI Data:
- NPI Number: 1336221373
- Provider Enumeration Date: 10/19/2006
- Last Update Date: 03/09/2024
Medical Identifiers
Medical identifiers for Dr Kenneth R Pride such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1336221373 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
103TC0700X | Psychologist - Clinical | 1583-057 (Wisconsin) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Kenneth R Pride is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Dr Kenneth R Pride, PHD 2129 So. Oneida, Ste: 113, Ashwaubenon, WI 54304 Ph: (920) 429-0159 | Dr Kenneth R Pride, PHD 2129 So. Oneida, Ste: 113, Ashwaubenon, WI 54304 Ph: (920) 429-0159 |
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