| Community Psychological Services Of Waupun Llc | |
|
1208 S Watertown St Waupun WI 53963-2309 | |
| (920) 324-4358 | |
| Not Available |
| Full Name | Community Psychological Services Of Waupun Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1208 S Watertown St, Waupun, Wisconsin |
| Authorized Official Name and Position | Robert Norman Deyoung (PSYCHOLOGIST CO-OWNER) |
| Authorized Official Contact | 9203244358 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Psychological Services Of Waupun Llc 1208 S Watertown St Waupun WI 53963-2309 Ph: (920) 324-4358 | Community Psychological Services Of Waupun Llc 1208 S Watertown St Waupun WI 53963-2309 Ph: (920) 324-4358 |
| NPI Number | 1225138126 |
|---|---|
| Provider Enumeration Date | 09/22/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225138126 | NPI | - | NPPES |
| 42127800 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 1228 (Wisconsin) | Primary |
Tammy Narance Lpc Sc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: W7185 Wi-49, Waupun, WI 53963 Phone: 608-218-4597 | |
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