| Becker-gibeau Psychological Services, Llc | |
|
14135 N Cedarburg Rd Suite 100 Mequon WI 53097-1416 | |
| (262) 377-2006 | |
| (262) 377-5552 |
| Full Name | Becker-gibeau Psychological Services, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 14135 N Cedarburg Rd, Mequon, Wisconsin |
| Authorized Official Name and Position | Paul Matthew Gibeau (PSYCHOLOGIST) |
| Authorized Official Contact | 2623772006 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Becker-gibeau Psychological Services, Llc 14135 N Cedarburg Rd Suite 100 Mequon WI 53097-1416 Ph: (262) 377-2006 | Becker-gibeau Psychological Services, Llc 14135 N Cedarburg Rd Suite 100 Mequon WI 53097-1416 Ph: (262) 377-2006 |
| NPI Number | 1972756013 |
|---|---|
| Provider Enumeration Date | 11/03/2008 |
| Last Update Date | 11/03/2008 |
| Medicare PECOS PAC ID | 1456415264 |
|---|---|
| Medicare Enrollment ID | O20090122000566 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972756013 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 2344-057 (Wisconsin) | Primary |
| 103TC0700X | Psychologist - Clinical | 2330-057 (Wisconsin) | Secondary |
| Provider Name | Carolyn J Becker |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1043363815 PECOS PAC ID: 3870657687 Enrollment ID: I20090122000594 |
| Provider Name | Paul M Gibeau |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1316083686 PECOS PAC ID: 9335203140 Enrollment ID: I20090122000604 |
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