Healthcare Psychology Consultants LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1912 Issued in WI

Legal business name

HEALTHCARE PSYCHOLOGY CONSULTANTS LLC

Practice address

4447 N Oakland Ave
Shorewood, WI 53211

Phone

(414) 431-4322

Fax

(414) 431-4323

NPI assigned

Mar 30, 2007

Last updated

Dec 4, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Michael Luther Jorn, PHDNPI 1073568697

Title

Clinical Psychologist Sole Owner

Phone

(414) 431-4322

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael Luther Jorn, PHD

  • Clinical Psychologist
  • Shorewood, WI
  • NPI 1073568697
  Medicare reassignment NPD Authorized official
• Mary Jane M Demet, MSW, LCSW

  • Clinical Social Worker
  • Milwaukee, WI
  • NPI 1841219169
  NPD
• Julia Bratton

  • Clinical Social Worker
  • Milwaukee, WI
  • NPI 1548627201
  NPD (past)
• Susan Jone Bloom, PSY. D., APNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Coconut Creek, FL
  • NPI 1396989141
  NPD (past)

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417651200000",
    "number": "1063532380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 N OLD WORLD 3RD ST STE 410",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532031121",
            "telephone_number": "414-431-4322",
            "fax_number": "414-431-4323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4447 N OAKLAND AVE",
            "city": "SHOREWOOD",
            "state": "WI",
            "postal_code": "53211",
            "telephone_number": "414-431-4322",
            "fax_number": "414-431-4323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHCARE PSYCHOLOGY CONSULTANTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-30",
        "last_updated": "2014-12-04",
        "status": "A",
        "authorized_official_last_name": "JORN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "LUTHER",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST SOLE OWNER",
        "authorized_official_telephone_number": "414-431-4322",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "WI",
            "license": "1912",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39113800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carolyn Griffin, DDS, MS
• Eva Gulotta, MS/CCC-SLP
• Tim Halverson, RDN
• Josephine Hayes-Birchler, DDS
• Health and Wellness Clinic of Shorewood, S.C.
• Danielle Henckel, RN
• Ryan Hermanstorfer
• Chelsea Loran Holtz, D.O
• Nancy Lee Hornby, MSW, CICSW
• Donna J. Horrigan, PT

• Clinical Psychologist in Shorewood, WI
• Providers in Shorewood, WI by specialty
• Clinical Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.