Provider Demographics
NPI:1821358185
Name:HENRY STEINBERGER PHD LLC
Entity Type:Organization
Organization Name:HENRY STEINBERGER PHD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:
Authorized Official - Last Name:STEINBERGER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:608-238-3894
Mailing Address - Street 1:313 PRICE PL
Mailing Address - Street 2:SUITE 209
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53705-3299
Mailing Address - Country:US
Mailing Address - Phone:608-238-3894
Mailing Address - Fax:608-238-3896
Practice Address - Street 1:313 PRICE PL
Practice Address - Street 2:SUITE 209
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53705-3262
Practice Address - Country:US
Practice Address - Phone:608-238-3894
Practice Address - Fax:608-238-3896
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-21
Last Update Date:2016-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1285-057103T00000X, 103TA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1285-057OtherPSYCHOLOGY LICENSE
WI1487688859Medicaid
WIWI27460001OtherMEDICARE PTAN
WIWI2746OtherMEDICARE PTAN ORGANIZATION
WIWI27460001Medicare PIN
WI1487688859Medicaid