Provider Demographics
NPI:1689770497
Name:HEALTH PSYCHOLOGY ASSOCIATES, S.C.
Entity Type:Organization
Organization Name:HEALTH PSYCHOLOGY ASSOCIATES, S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:S
Authorized Official - Last Name:FULLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-962-4048
Mailing Address - Street 1:5800 N. BAYSHORE DR
Mailing Address - Street 2:SUITE B230
Mailing Address - City:GLENDALE
Mailing Address - State:WI
Mailing Address - Zip Code:53217-4503
Mailing Address - Country:US
Mailing Address - Phone:414-962-4048
Mailing Address - Fax:414-962-4052
Practice Address - Street 1:5800 N. BAYSHORE DR
Practice Address - Street 2:SUITE B230
Practice Address - City:GLENDALE
Practice Address - State:WI
Practice Address - Zip Code:53217-4503
Practice Address - Country:US
Practice Address - Phone:414-962-4048
Practice Address - Fax:414-962-4052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
Not Answered104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty