| The Samuel Center For Psychological Services | |
|
4465 N Oakland Ave Shorewood WI 53211-1662 | |
| (414) 847-9351 | |
| Not Available |
| Full Name | The Samuel Center For Psychological Services |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 4465 N Oakland Ave, Shorewood, Wisconsin |
| Authorized Official Name and Position | Carol Yvonne Smith (CEO/PRESIDENT) |
| Authorized Official Contact | 4143543620 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Samuel Center For Psychological Services 4465 N Oakland Ave Shorewood WI 53211-1662 Ph: (414) 354-3620 | The Samuel Center For Psychological Services 4465 N Oakland Ave Shorewood WI 53211-1662 Ph: (414) 847-9351 |
| NPI Number | 1841372703 |
|---|---|
| Provider Enumeration Date | 10/20/2006 |
| Last Update Date | 01/17/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841372703 | NPI | - | NPPES |
| 42201900 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 1924 (Wisconsin) | Primary |
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