Active NPI
Torria Van Buren, PSY.D
- Psychologist
- Waupun, WI
National Provider Identifier
1053761742
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 3208-57
- Practice address
- 200 S Madison St
Waupun, WI 53963-2000 - Phone
- (920) 324-5571
- NPI assigned
- Jun 14, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 3208-57 | WI | Primary |
Addresses
Primary practice location
200 S Madison St
Waupun, WI 53963-2000
Mailing address
200 S Madison St
Waupun, WI 53963-2000
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3208-57 | WI | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Foot Clinic, SC | Past | Accepting new patients | |
| Glassman & Stanik Consulting Psychologists, LLC | Psychologist | Past | Accepting new patients |
Organizations & group practices 2
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.
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- Fond Du Lac, WI
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-
- Clinical Neuropsychologist
- Milwaukee, WI
- NPI 1720105877
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1465862400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1475712000000",
"number": "1053761742",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 S MADISON ST",
"city": "WAUPUN",
"state": "WI",
"postal_code": "539632000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 S MADISON ST",
"city": "WAUPUN",
"state": "WI",
"postal_code": "539632000",
"telephone_number": "920-324-5571"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAN BUREN",
"first_name": "TORRIA",
"name_prefix": "Dr.",
"credential": "PSY.D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-06-14",
"last_updated": "2016-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "WI",
"license": "3208-57",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waupun, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.