| Lake Geneva Psychology, Inc. | |
|
630 Kenosha St Walworth WI 53184-9505 | |
| (305) 989-9030 | |
| Not Available |
| Full Name | Lake Geneva Psychology, Inc. |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 630 Kenosha St, Walworth, Wisconsin |
| Authorized Official Name and Position | Amy Sosa (DIRECTOR/OWNER) |
| Authorized Official Contact | 3059899030 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Geneva Psychology, Inc. N1330 Overland Ln Lake Geneva WI 53147-7302 Ph: (305) 989-9030 | Lake Geneva Psychology, Inc. 630 Kenosha St Walworth WI 53184-9505 Ph: (305) 989-9030 |
| NPI Number | 1972124980 |
|---|---|
| Provider Enumeration Date | 04/30/2020 |
| Last Update Date | 04/30/2020 |
| Certification Date | 04/30/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972124980 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
Center For Change, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 129 Kenosha St, Walworth, WI 53184 Phone: 262-607-2770 |