Kerry Wayne Lynch, PH.D.
Individual provider Active NPI Counseling Psychologist · Ixonia, WI
NPI 1043239676 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1043239676
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counseling Psychologist 103TC1900X
- License
- 1458057 (WI)
- Practice address
- 8380 North St.
Ixonia, WI 53036 - Phone
- (262) 569-0811
- NPI assigned
- Jul 18, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1458057 | WI | MD | Counseling Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | 1458057 | WI | Yes |
Addresses
Primary practice location
8380 North St.
Ixonia, WI 53036
Mailing address
5000 W National Ave
Milwaukee, WI 53295-0001
Phone (414) 384-2000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 14580057 | Other | WI | PSYCHOLOGIST |
Other providers in Ixonia, WI
- Linda Olson Douglas
- Duffy David Eberhardt
- Jennifer Michele Gates
- Kim M Jaeger
- Amy L Lauersdorf
- Jessica M Nevermann
- Alissa Olson
- Beth Marie Pape
- Town of Ixonia
- Watertown Regional Medical Center Inc
All providers in Ixonia, WI · Counseling Psychologist in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.