| Lynn Fitzsimmons Llc | |
|
216 Green Bay Rd Ste 108 Thiensville WI 53092 | |
| (414) 861-2174 | |
| Not Available |
| Full Name | Lynn Fitzsimmons Llc |
|---|---|
| Speciality | Psychologist |
| Location | 216 Green Bay Rd Ste 108, Thiensville, Wisconsin |
| Authorized Official Name and Position | Lynn Fitzsimmons (PH.D.) |
| Authorized Official Contact | 4148612174 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lynn Fitzsimmons Llc 1482 W. Windpointe Court Mequon WI 53092-1188 Ph: (414) 861-2174 | Lynn Fitzsimmons Llc 216 Green Bay Rd Ste 108 Thiensville WI 53092 Ph: (414) 861-2174 |
| NPI Number | 1487940250 |
|---|---|
| Provider Enumeration Date | 06/21/2011 |
| Last Update Date | 12/27/2018 |
| Medicare PECOS PAC ID | 6507034188 |
|---|---|
| Medicare Enrollment ID | O20110726000753 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487940250 | NPI | - | NPPES |
| 1629397815 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 2941057 (Wisconsin) | Primary |
| Provider Name | Lynn M Fitzsimmons |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1629397815 PECOS PAC ID: 3577731165 Enrollment ID: I20110824000552 |
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