| Krista Supinger Psychological Services | |
|
333 W Brown Deer Rd Unit G1202 Milwaukee WI 53217-2372 | |
| (414) 745-9325 | |
| Not Available |
| Full Name | Krista Supinger Psychological Services |
|---|---|
| Speciality | Clinic/Center |
| Location | 333 W Brown Deer Rd Unit G1202, Milwaukee, Wisconsin |
| Authorized Official Name and Position | Krista M Supinger (LICENSED PSYCHOLOGIST) |
| Authorized Official Contact | 4147459325 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Krista Supinger Psychological Services 333 W Brown Deer Rd Unit G1202 Milwaukee WI 53217-2372 Ph: () - | Krista Supinger Psychological Services 333 W Brown Deer Rd Unit G1202 Milwaukee WI 53217-2372 Ph: (414) 745-9325 |
| NPI Number | 1942933163 |
|---|---|
| Provider Enumeration Date | 07/05/2022 |
| Last Update Date | 08/23/2024 |
| Certification Date | 08/23/2024 |
| Medicare PECOS PAC ID | 6800270299 |
|---|---|
| Medicare Enrollment ID | O20220902001921 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942933163 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Krista Marie Supinger |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1457770398 PECOS PAC ID: 9335426329 Enrollment ID: I20170428001491 |
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