| Clear Direction Psychological Services, Inc. | |
|
6110 N Port Washington Rd Glendale WI 53217-4308 | |
| (414) 332-3390 | |
| (414) 332-3392 |
| Full Name | Clear Direction Psychological Services, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 6110 N Port Washington Rd, Glendale, Wisconsin |
| Authorized Official Name and Position | Frank Urtz (PRESIDENT) |
| Authorized Official Contact | 4143323390 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Clear Direction Psychological Services, Inc. 6110 N Port Washington Rd Glendale WI 53217-4308 Ph: (414) 332-3390 | Clear Direction Psychological Services, Inc. 6110 N Port Washington Rd Glendale WI 53217-4308 Ph: (414) 332-3390 |
| NPI Number | 1558586016 |
|---|---|
| Provider Enumeration Date | 04/17/2007 |
| Last Update Date | 04/18/2013 |
| Medicare PECOS PAC ID | 1850283417 |
|---|---|
| Medicare Enrollment ID | O20040327000369 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558586016 | NPI | - | NPPES |
| 166708 | Other | WI | MANAGED HEALTH NETWORK |
| V543N | Other | WI | BLUE CROSS BLUE SHIELD |
| 157211 | Other | WI | VALUEOPTIONS PROVIDER |
| 39020900 | Medicaid | WI | |
| 4017291 | Other | WI | AETNA PROVIDER NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (Wisconsin) | Primary |
| Provider Name | Frank P Urtz |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1912093162 PECOS PAC ID: 8022900695 Enrollment ID: I20040331000738 |
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