Patricia Lee Bromley, PH.D.

Individual provider Active NPI Psychologist · Whitewater, WI

NPI 1194790063 · NPPES record last updated Dec 30, 2010

Key facts

NPI
1194790063
Entity type
Individual (NPI type 1)
Primary specialty
Psychologist 103T00000X
License
1885-057 (WI)
Practice address
162 W Main St Ste G
Whitewater, WI 53190-1995
Phone
(262) 495-8531
Fax
(262) 495-8532
NPI assigned
Feb 22, 2006
Sex
Female
Sole proprietor
Yes

Organizations & group practices 2

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

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1885-057WIMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
WKM Psychology Clinics, Inc. Psychologist Past
since Mar 15, 2018
Accepting new patients
Mindful Psychotherapy Services LLC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X 1885-057 WI
Psychologist 103T00000X 1885-057 WI Yes

Addresses

Primary practice location

162 W Main St Ste G
Whitewater, WI 53190-1995

Mailing address

W5838 Greening Rd
Whitewater, WI 53190-4026
Phone (262) 495-8531

Other providers in Whitewater, WI

All providers in Whitewater, WI · Psychologist in Wisconsin

Sources for this page

Verify at the official NPI Registry.