Andrea Labine, PH.D LLC
Organization Active NPI Clinical Psychologist · Green Bay, WI
NPI 1245688993 · NPPES record last updated Jun 2, 2016
Key facts
- NPI
- 1245688993
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Psychologist 103TC0700X
- Legal business name
- ANDREA LABINE, PH.D LLC
- Practice address
- 1039 W Mason St
116
Green Bay, WI 54303-1842 - Phone
- (920) 965-7713
- Fax
- (920) 496-7922
- NPI assigned
- Jun 2, 2016
- Organization subpart
- No
Authorized official
- Name
- Dr. Andrea Labine, PH.D.
- Title
- Owner-Clinical Psychologist
- Phone
- (920) 965-7713
Practitioners 1
-
Andrea Labine, PH.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20161102000984 | WI | Part B Supplier - Clinic/Group Practice | 8921386590 |
Receives reassigned benefits from 1 practitioner Practice locations: Green Bay, WI |
National Provider Directory
Locations
1039 W Mason St
#116
Green Bay, WI 54303
Phone (920) 965-7713
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist |
103TC0700X | Yes |
Addresses
Primary practice location
1039 W Mason St
116
Green Bay, WI 54303-1842
Mailing address
1039 W Mason St
116
Green Bay, WI 54303-1842
Phone (920) 965-7713
Other providers in Green Bay, WI
- Sara Ann Anderson
- Sara L Anderson
- Sara Lynn Anderson
- Sarah Lynn Anderson
- Shannon M Anderson
- Joao Vitor Andreoli Saltao
- Todd Matthew Andres
- Andresource, LLC
- John Frederick Andrews
- Alyxandria Kathryn Andrus
All providers in Green Bay, WI · Clinical Psychologist in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 2, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.