Active NPI
Joseph Haney, PSY.D.
- Psychologist
- Fond Du Lac, WI
National Provider Identifier
1285859678
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 2044-057
- Practice address
- 459 E 1St St
Fond Du Lac, WI 54935-4505 - Phone
- (920) 929-3527
- NPI assigned
- Apr 13, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 2044-057 | WI | Primary |
Addresses
Primary practice location
459 E 1St St
Fond Du Lac, WI 54935-4505
Mailing address
459 E 1St St
Fond Du Lac, WI 54935-4505
Phone (920) 929-3527
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 39721500 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2044-057 | WI | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Christian Counseling Associates LLC | Psychologist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Psychologist
- Brookfield, WI
- NPI 1164736088
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176422400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1200960000000",
"number": "1285859678",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "459 E 1ST ST",
"city": "FOND DU LAC",
"state": "WI",
"postal_code": "549354505",
"telephone_number": "920-929-3527"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "459 E 1ST ST",
"city": "FOND DU LAC",
"state": "WI",
"postal_code": "549354505",
"telephone_number": "920-929-3527"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANEY",
"first_name": "JOSEPH",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-13",
"last_updated": "2008-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "WI",
"license": "2044-057",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "39721500",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fond Du Lac, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 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.