Summit Psychology Clinic SC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

SUMMIT PSYCHOLOGY CLINIC SC

Practice address

933 N Mayfair Rd
Ste 303
Wauwatosa, WI 53226

Phone

(414) 258-8488

Fax

(414) 258-8838

NPI assigned

May 22, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Jeanne Marie Herzog, PHD

Title

Clinical Director Psychologist

Phone

(414) 258-8488

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1073722211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "933 N MAYFAIR RD",
            "address_2": "STE 303",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "53226",
            "telephone_number": "414-258-8488",
            "fax_number": "414-258-8838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "933 N MAYFAIR RD",
            "address_2": "STE 303",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "53226",
            "telephone_number": "414-258-8488",
            "fax_number": "414-258-8838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT PSYCHOLOGY CLINIC SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HERZOG",
        "authorized_official_first_name": "JEANNE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR PSYCHOLOGIST",
        "authorized_official_telephone_number": "414-258-8488",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Suh, MD
• Perry Wayne Sukowatey, DDS
• Tanielle Summerill, PTA
• Summit Eye Care of Wisconsin SC
• Summit Health & Medical LLC
• Supportive Homecare Options, Inc
• Susan Powers MD
• Suson Eye Specialists, MD SC
• Suson Optical Corporation
• John Swart

• Mental Health Clinic/Center (Including Community Mental Health Center) in Wauwatosa, WI
• Providers in Wauwatosa, WI by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.