| Brian M. Fidlin Psychological Services | |
|
14135 N Cedarburg Rd Mequon WI 53097-1416 | |
| (262) 377-2006 | |
| Not Available |
| Full Name | Brian M. Fidlin Psychological Services |
|---|---|
| Speciality | Clinic/Center |
| Location | 14135 N Cedarburg Rd, Mequon, Wisconsin |
| Authorized Official Name and Position | Brian Michael Fidlin (CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 4148376391 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brian M. Fidlin Psychological Services Po Box 171009 Milwaukee WI 53217-8092 Ph: (414) 837-6391 | Brian M. Fidlin Psychological Services 14135 N Cedarburg Rd Mequon WI 53097-1416 Ph: (262) 377-2006 |
| NPI Number | 1467923474 |
|---|---|
| Provider Enumeration Date | 12/17/2018 |
| Last Update Date | 06/20/2019 |
| Medicare PECOS PAC ID | 6507199726 |
|---|---|
| Medicare Enrollment ID | O20190603002630 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467923474 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Brian M Fidlin |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1083720759 PECOS PAC ID: 7012986508 Enrollment ID: I20040930001034 |
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