M D Therapy, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

HFS 61.91 Issued in WI

Legal business name

M D THERAPY, LLC

Practice address

6815 W Capitol Dr
Suite 208
Milwaukee, WI 53216-2070

Phone

(414) 466-3204

Fax

(414) 466-3206

NPI assigned

Oct 1, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Thomas Michael Dale, ED PSYCHOLOGY

Title

Psychoterapist

Phone

(414) 466-3204

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Directors of Continuation Services2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• M D Therapy LLC

  • Marriage & Family Therapist
  • Milwaukee, WI
  • NPI 1811193675
  NPD tax ID

Locations

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

{
    "created_epoch": "1191196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219708800000",
    "number": "1144417304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6815 W CAPITOL DR",
            "address_2": "SUITE 208",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532162070",
            "telephone_number": "414-466-3204",
            "fax_number": "414-466-3206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6815 W CAPITOL DR",
            "address_2": "SUITE 208",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532162070",
            "telephone_number": "414-466-3204",
            "fax_number": "414-466-3206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M D THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-01",
        "last_updated": "2008-08-26",
        "status": "A",
        "authorized_official_last_name": "DALE",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PSYCHOTERAPIST",
        "authorized_official_telephone_number": "414-466-3204",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "ED PSYCHOLOGY"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "WI",
            "license": "HFS 61.91",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42217600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• M D Therapy LLC
• M J Mishefske MD SC
• M. L. Tharps & Associates LLC
• M.a.B Health Services LLC
• M.a.T.C.H.
• M.C. Preparatory School of Wisconsin Inc (Milwaukee College Prep)

• Community/Behavioral Health Agency in Milwaukee, WI
• Providers in Milwaukee, 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 Aug 26, 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.