Provider Demographics
NPI:1760432777
Name:WINSTON, ELIZABETH H (PHD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:H
Last Name:WINSTON
Suffix:
Gender:F
Credentials:PHD
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Other - First Name:
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Mailing Address - Street 1:6510 GRAND TETON PLZ
Mailing Address - Street 2:SUITE 2
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53719-1029
Mailing Address - Country:US
Mailing Address - Phone:608-833-9290
Mailing Address - Fax:608-833-9691
Practice Address - Street 1:6510 GRAND TETON PLZ
Practice Address - Street 2:SUITE 2
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53719-1029
Practice Address - Country:US
Practice Address - Phone:608-833-9290
Practice Address - Fax:608-833-9691
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2009-03-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI2460-057103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI39150300Medicaid
WI999026768OtherWPS
WI13634OtherDEAN HEALTH PLAN
WI999026768OtherWPS