| Richard A Hohfeler Iii Psyd, S.c. | |
|
10045 W Lisbon Ave Wauwatosa WI 53222-2446 | |
| (414) 351-7151 | |
| (414) 393-1640 |
| Full Name | Richard A Hohfeler Iii Psyd, S.c. |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 10045 W Lisbon Ave, Wauwatosa, Wisconsin |
| Authorized Official Name and Position | Richard August Hohfeler (PRESIDENT) |
| Authorized Official Contact | 2625698399 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Richard A Hohfeler Iii Psyd, S.c. 4329 N Sawyer Rd Oconomowoc WI 53066-4551 Ph: (262) 569-8399 | Richard A Hohfeler Iii Psyd, S.c. 10045 W Lisbon Ave Wauwatosa WI 53222-2446 Ph: (414) 351-7151 |
| NPI Number | 1760649354 |
|---|---|
| Provider Enumeration Date | 05/21/2008 |
| Last Update Date | 10/20/2010 |
| Medicare PECOS PAC ID | 2466645528 |
|---|---|
| Medicare Enrollment ID | O20101021000125 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760649354 | NPI | - | NPPES |
| 41277 | Other | WI | NATIONAL REGISTER FOR HEALTH SERVICE PROVIDERS IN PSYCHOLOGY |
| 39077400 | Medicaid | WI | |
| 1295 | Other | WI | PSYCHOLOGY LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 1295 (Wisconsin) | Primary |
| Provider Name | Richard A Hohfeler |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1881694701 PECOS PAC ID: 8022060854 Enrollment ID: I20080508000788 |
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