Provider Demographics
NPI:1255631255
Name:HEALYHANEY, NANCY M (PSYD)
Entity type:Individual
Prefix:DR
First Name:NANCY
Middle Name:M
Last Name:HEALYHANEY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:NANCY
Other - Middle Name:M
Other - Last Name:HEALYHANEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD
Mailing Address - Street 1:309 E NORTH ST
Mailing Address - Street 2:
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53188-3718
Mailing Address - Country:US
Mailing Address - Phone:262-786-9184
Mailing Address - Fax:262-786-9106
Practice Address - Street 1:17100 W NORTH AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53005-4436
Practice Address - Country:US
Practice Address - Phone:262-786-9184
Practice Address - Fax:262-786-9106
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-25
Last Update Date:2019-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2134057103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical