Professional Psychological Services, SC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

1746 Issued in WI

Legal business name

PROFESSIONAL PSYCHOLOGICAL SERVICES, SC

Practice address

441 Milwaukee Ave Ste 2
Burlington, WI 53105-1230

Phone

(262) 767-0440

Fax

(262) 767-0777

NPI assigned

Jan 22, 2008

Last updated

Jan 22, 2008By 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

Dr. Dean Edward Stolldorf, PHDNPI 1194789032

Title

Clinical Director

Phone

(262) 767-0440

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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.

• Dean Edward Stolldorf, PSYCHOLOGIST

  • Psychologist
  • Burlington, WI
  • NPI 1194789032
  Authorized official Same address or phone

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

{
    "created_epoch": "1200960000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200960000000",
    "number": "1134306103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "441 MILWAUKEE AVE STE 2",
            "city": "BURLINGTON",
            "state": "WI",
            "postal_code": "531051230",
            "telephone_number": "262-767-0440",
            "fax_number": "262-767-0777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "441 MILWAUKEE AVE STE 2",
            "city": "BURLINGTON",
            "state": "WI",
            "postal_code": "531051230",
            "telephone_number": "262-767-0440",
            "fax_number": "262-767-0777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL PSYCHOLOGICAL SERVICES, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-22",
        "last_updated": "2008-01-22",
        "status": "A",
        "authorized_official_last_name": "STOLLDORF",
        "authorized_official_first_name": "DEAN",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "262-767-0440",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "WI",
            "license": "1746",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42155900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Sara Frances Prelog, MSW
• Timothy M Pritzl, OD
• Private Healthcare Facilities
• Donna Jeanne Przybylinski, M.A.
• Charles Anthony Puntillo, DDS
• Purath Headache & Neurology, S.C.
• Traci A. Purath, M.D.
• Ramakrishna P Venugopalan MD SC

• Community/Behavioral Health Agency in Burlington, WI
• Providers in Burlington, WI by specialty
• Community/Behavioral Health Agency in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2008; 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.