| Sun Prairie Psychological Llc | |
|
750 Windsor St Ste 208 Sun Prairie WI 53590-2149 | |
| (608) 825-6663 | |
| (608) 825-6946 |
| Full Name | Sun Prairie Psychological Llc |
|---|---|
| Speciality | Psychologist |
| Location | 750 Windsor St Ste 208, Sun Prairie, Wisconsin |
| Authorized Official Name and Position | Mindy E Haseleu (PSYCHOLOGIST) |
| Authorized Official Contact | 9209884520 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sun Prairie Psychological Llc 750 Windsor St Ste 208 Sun Prairie WI 53590-2149 Ph: (608) 825-6663 | Sun Prairie Psychological Llc 750 Windsor St Ste 208 Sun Prairie WI 53590-2149 Ph: (608) 825-6663 |
| NPI Number | 1316766082 |
|---|---|
| Provider Enumeration Date | 10/09/2024 |
| Last Update Date | 10/09/2024 |
| Certification Date | 10/09/2024 |
| Medicare PECOS PAC ID | 2466986138 |
|---|---|
| Medicare Enrollment ID | O20241118001768 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316766082 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Mindy E Haseleu |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1760490205 PECOS PAC ID: 0840393419 Enrollment ID: I20070320000344 |
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