Susan Dvorak, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

1423-057 Issued in WI

Practice address

9120 W Hampton Ave
Suite 90
Milwaukee, WI 53225-4960

Phone

(414) 466-9777

Fax

(414) 358-5590

NPI assigned

May 18, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Wisconsin School of Professional Psychology

  dba WSPP Psychology Center

  • Psychologist
  • Milwaukee, WI
  • NPI 1902011257
  NPD (past) Authorized official

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1144438672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 N 85TH ST",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532264601",
            "telephone_number": "414-259-8938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9120 W HAMPTON AVE",
            "address_2": "SUITE 90",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532254960",
            "telephone_number": "414-466-9777",
            "fax_number": "414-358-5590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DVORAK",
        "first_name": "SUSAN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "1423-057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39094500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ledia Duvnjak
• Petar Duvnjak, M.D.
• Claire Duwell
• Dva Renal Healthcare Inc (Wisconsin Avenue Dialysis)
• Dva Renal Healthcare Inc (River Center Dialysis)
• Bhargavi Dwadasi, DDS
• Justin J Dworak, APNP, CRNA
• Christopher Harper Dwyer, D.C.
• Daniel Patrick Dwyer, MD
• Taylor Dwyer

• Psychologist in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.