Psychological Purposes Llc | |
3229 S Adams Ave Milwaukee WI 53207-2705 | |
(773) 398-4648 | |
Not Available |
Full Name | Psychological Purposes Llc |
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Speciality | Psychologist |
Location | 3229 S Adams Ave, Milwaukee, Wisconsin |
Authorized Official Name and Position | Benjamin Rader (PSYCHOLOGIST) |
Authorized Official Contact | 2627801405 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Psychological Purposes Llc 3229 S Adams Ave Milwaukee WI 53207-2705 Ph: () - | Psychological Purposes Llc 3229 S Adams Ave Milwaukee WI 53207-2705 Ph: (773) 398-4648 |
NPI Number | 1538590393 |
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Provider Enumeration Date | 12/04/2013 |
Last Update Date | 12/04/2013 |
Medicare PECOS PAC ID | 7719119320 |
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Medicare Enrollment ID | O20140415000015 |
Identifier | Type | State | Issuer |
---|---|---|---|
1538590393 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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103T00000X | Psychologist | 294557 (Wisconsin) | Primary |
Provider Name | Benjamin M Rader |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1114162187 PECOS PAC ID: 1355573965 Enrollment ID: I20140415000048 |
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