Provider Demographics
NPI:1801952700
Name:ASSOCIATED WOMEN PSYCHOTHERAPISTS, SC
Entity type:Organization
Organization Name:ASSOCIATED WOMEN PSYCHOTHERAPISTS, SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:KATHIE
Authorized Official - Last Name:WYSZKOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-476-2699
Mailing Address - Street 1:10625 W. NORTH AVENUE
Mailing Address - Street 2:#208
Mailing Address - City:WAUWATOSA
Mailing Address - State:WI
Mailing Address - Zip Code:53226
Mailing Address - Country:US
Mailing Address - Phone:414-476-2699
Mailing Address - Fax:414-476-9643
Practice Address - Street 1:10625 W. NORTH AVENUE
Practice Address - Street 2:#208
Practice Address - City:WAUWATOSA
Practice Address - State:WI
Practice Address - Zip Code:53226
Practice Address - Country:US
Practice Address - Phone:414-476-2699
Practice Address - Fax:414-476-9643
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-28
Last Update Date:2011-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI988-057103T00000X
WI124-057103T00000X
WI2144-057103T00000X
WI20250-0202084P0800X
261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI42121300Medicaid
WI000084647Medicare UPIN