Lawrence J Mandt, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

1610-57 Issued in WI

Practice address

2254 Monroe St
Madison, WI 53711-1902

Phone

(608) 223-9767

NPI assigned

Jul 4, 2006

Last updated

Aug 9, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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.

• Elkhart Psychological Services, LLC

  • Clinical Psychologist
  • Monona, WI
  • NPI 1265554430
  Authorized official Same address or phone
• Madison Neuropsychological Services LLC

  • Clinical Neuropsychologist
  • Madison, WI
  • NPI 1982064366
  NPD (past)

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691539200000",
    "number": "1255361002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "S88W25730 EDGEWOOD AVE",
            "city": "MUKWONAGO",
            "state": "WI",
            "postal_code": "531499609",
            "telephone_number": "262-706-3391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2254 MONROE ST",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537111902",
            "telephone_number": "608-223-9767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDT",
        "first_name": "LAWRENCE",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "1610-57",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WI",
            "license": "1610",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39088600",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIANS PLUS ID NUMBER",
            "identifier": "1011078",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christopher B Mandel, M.D.
• Didier Mandelbrot, M.D.
• Julie Ann Mandli, PT
• Sarah Mandli, MS, RDN, LDN
• Eleanor Mandt, MA, BCBA
• Ashley Mangan
• Paul Matthew Manganaro
• Teresa M. Mangin, MD
• Manifest Wellness, LLC
• Allison Joy Mankovecky, MFT-IT

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.