Individual provider Active NPI

Christopher Joseph Daood

  • Psychologist
  • Glendale, WI
National Provider Identifier
1013778588
Registry record updated Jan 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
3084-57 Issued in WI
Practice address
950 W Riverview Dr
Glendale, WI 53209-4534
Phone
(414) 617-3704
NPI assigned
Jan 22, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 3084-57 WI Primary

Addresses

Primary practice location

950 W Riverview Dr
Glendale, WI 53209-4534

Mailing address

950 W Riverview Dr
Glendale, WI 53209-4534
Phone (414) 617-3704

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
3084-57WIMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
A Moment of Retreat, LLC Psychologist CurrentSince Jan 28, 2024 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1705881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705881600000",
    "number": "1013778588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 W RIVERVIEW DR",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532094534",
            "telephone_number": "414-617-3704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 W RIVERVIEW DR",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532094534",
            "telephone_number": "414-617-3704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAOOD",
        "first_name": "CHRISTOPHER",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-22",
        "last_updated": "2024-01-22",
        "certification_date": "2024-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "3084-57",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2024; 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.