William James Skalecki

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

120 N Main St Ste 110
West Bend, WI 53095-3353

Phone

(262) 707-3052

NPI assigned

Feb 21, 2022

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1645401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645401600000",
    "number": "1013662709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W69N463 FOXPOINTE AVE",
            "city": "CEDARBURG",
            "state": "WI",
            "postal_code": "530122231",
            "telephone_number": "262-707-3052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 N MAIN ST STE 110",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530953353",
            "telephone_number": "262-707-3052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKALECKI",
        "first_name": "WILLIAM",
        "middle_name": "JAMES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-21",
        "last_updated": "2022-02-21",
        "certification_date": "2022-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.lifespanpsychologicalservices.com/",
            "affiliation": "N",
            "endpointDescription": "Website",
            "address_1": "13035 W Bluemound Rd Ste 100",
            "city": "Brookfield",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530058001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kimberly B Sievert, DPT
• Kristina Marie Simpson
• Braden M Sims, DC
• Renee Sinopoli, MD
• Janet L Sivula, R.N.
• Anne Marie Skalmoski, P.T.
• Jennifer Skinner
• Benjamin T Skubal
• Jeffery R Smale, MD
• Dianne Marie Smith-O'Connor, LCSW

• All providers in West Bend, WI
• Student in an Organized Health Care Education/Training Program in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.