Dawn M Pflugradt, PSY. D.
Individual provider Active NPI Clinical Psychologist · Waupaca, WI
NPI 1083781488 · NPPES record last updated Apr 29, 2014
Key facts
- NPI
- 1083781488
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 2876-057 (WI)
- Practice address
- 104 N Main St Ste 120
Waupaca, WI 54981-1594 - Phone
- (414) 552-6289
- Fax
- (920) 257-4603
- NPI assigned
- Nov 29, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2876-057 | WI | MD | Clinical Psychologist |
| 7074 123 | WI | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Comprehensive Health Law Services, LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 7074 123 | WI | |
| Clinical Psychologist | 103TC0700X | 2876-057 | WI | Yes |
Addresses
Primary practice location
104 N Main St Ste 120
Waupaca, WI 54981-1594
Mailing address
104 N Main St Ste 120
Waupaca, WI 54981-1594
Phone (414) 552-6289
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 40939300 | Medicaid | WI |
Other providers in Waupaca, WI
- Partnership Community Health Center, Inc
- Gabrielle Ann Patri
- Nancy Ann Pejsa
- Melissa Perzinski
- Robert Lester Peterson
- Diane Catherine Phelan
- Amanda Cleary Pickart
- Bruce Allen Pierson
- Aaron Wayne Plachetka
- Morgan Platta
All providers in Waupaca, WI · Clinical 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 Apr 29, 2014. 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.