| Scott L Fenton, Psyd, Llc | |
|
5900 Monona Dr Ste 408 Monona WI 53716-3561 | |
| (608) 628-3963 | |
| (608) 501-0978 |
| Full Name | Scott L Fenton, Psyd, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 5900 Monona Dr Ste 408, Monona, Wisconsin |
| Authorized Official Name and Position | Scott L Fenton (SOLE PROPRIETOR) |
| Authorized Official Contact | 6086283963 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Scott L Fenton, Psyd, Llc 5900 Monona Dr Ste 408 Monona WI 53716-3561 Ph: (608) 628-3963 | Scott L Fenton, Psyd, Llc 5900 Monona Dr Ste 408 Monona WI 53716-3561 Ph: (608) 628-3963 |
| NPI Number | 1740440924 |
|---|---|
| Provider Enumeration Date | 06/11/2008 |
| Last Update Date | 07/15/2021 |
| Certification Date | 07/15/2021 |
| Medicare PECOS PAC ID | 2668547407 |
|---|---|
| Medicare Enrollment ID | O20080813000765 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740440924 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 2531057 (Wisconsin) | Primary |
| Provider Name | Scott L Fenton |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1457527764 PECOS PAC ID: 4486729225 Enrollment ID: I20080813000754 |
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