Michael Matthew Mihajlovic, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

3080-57 Issued in WI

Practice address

4536 22ND Ave
Kenosha, WI 53140-5917

Phone

(262) 656-0044

Fax

(262) 653-2218

NPI assigned

Sep 14, 2007

Last updated

Apr 3, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1189728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396483200000",
    "number": "1124213954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4536 22ND AVE",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531405917",
            "telephone_number": "262-656-0044",
            "fax_number": "262-653-2218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4536 22ND AVE",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531405917",
            "telephone_number": "262-656-0044",
            "fax_number": "262-653-2218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIHAJLOVIC",
        "first_name": "MICHAEL",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-14",
        "last_updated": "2014-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WI",
            "license": "3080-57",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Midwest Family Support Services
• Midwest Kidney Care, LLC (Midwest Kidney Care-Kenosha Branch)
• Midwest Physicians Anesthesia Service, SC
• Midwest Sports and Interventional Spine SC
• Julie E Miesfeld, PT
• Chad T Mikesell, PT
• Sandra L Mikolas, APNP
• Lisa Milczarski
• Larissa Milicevic, LPC
• Dawn Miller-Duval, LPC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2014; 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.