| Comprehensive Clinical And Consulting Services, Inc | |
|
7161 N Port Washington Rd Suite 102 Milwaukee WI 53217-3877 | |
| (414) 352-7682 | |
| (414) 352-7625 |
| Full Name | Comprehensive Clinical And Consulting Services, Inc |
|---|---|
| Speciality | Psychologist |
| Location | 7161 N Port Washington Rd, Milwaukee, Wisconsin |
| Authorized Official Name and Position | Itzhak Matusiak (CLINIC DIRECTOR) |
| Authorized Official Contact | 4143527682 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Comprehensive Clinical And Consulting Services, Inc 7161 N Port Washington Rd Suite 102 Milwaukee WI 53217-3877 Ph: (414) 352-7682 | Comprehensive Clinical And Consulting Services, Inc 7161 N Port Washington Rd Suite 102 Milwaukee WI 53217-3877 Ph: (414) 352-7682 |
| NPI Number | 1487830790 |
|---|---|
| Provider Enumeration Date | 01/16/2008 |
| Last Update Date | 01/16/2008 |
| Medicare PECOS PAC ID | 2466417746 |
|---|---|
| Medicare Enrollment ID | O20041129000434 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487830790 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 1233 (Wisconsin) | Primary |
| Provider Name | Itzhak Matusiak |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1033276282 PECOS PAC ID: 2860481967 Enrollment ID: I20040512000150 |
| Provider Name | Constanz W Hartney |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1467572677 PECOS PAC ID: 7315917762 Enrollment ID: I20080402000473 |
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