Provider Demographics
NPI:1518734730
Name:RUSINAK PSYCHOLOGY LLC
Entity Type:Organization
Organization Name:RUSINAK PSYCHOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SETA
Authorized Official - Middle Name:
Authorized Official - Last Name:RUSINAK
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:608-535-9428
Mailing Address - Street 1:715 HILL ST STE 132
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53705-3572
Mailing Address - Country:US
Mailing Address - Phone:608-535-9428
Mailing Address - Fax:608-621-3771
Practice Address - Street 1:715 HILL ST STE 132
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53705-3572
Practice Address - Country:US
Practice Address - Phone:608-535-9428
Practice Address - Fax:608-621-3771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-07
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty