Organization Active NPI

Tammy Giannopoulos, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Greenfield, WI
National Provider Identifier
1295139012
Registry record updated Oct 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
7779-123 Issued in WI
Legal business name
TAMMY GIANNOPOULOS, LLC
Practice address
4402 S 68TH St Suite 100
Greenfield, WI 53220
Phone
(414) 331-8167
Fax
(414) 321-0552
NPI assigned
Oct 22, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2014

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

Authorized official

Name
Tammy Giannopoulos, LCSW
Title
Psychotherapist
Phone
(414) 331-8167

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 7779-123 WI Primary

Addresses

Primary practice location

4402 S 68TH St Suite 100
Greenfield, WI 53220

Mailing address

4402 S 68TH St Suite 100
Greenfield, WI 53220
Phone (414) 331-8167

Other identifiers 1

IdentifierTypeStateIssuer
100016425MedicaidWI

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1413936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413936000000",
    "number": "1295139012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4402 S 68TH ST SUITE 100",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "53220",
            "telephone_number": "414-331-8167",
            "fax_number": "414-321-0552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4402 S 68TH ST SUITE 100",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "53220",
            "telephone_number": "414-331-8167",
            "fax_number": "414-321-0552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAMMY GIANNOPOULOS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-22",
        "last_updated": "2014-10-22",
        "status": "A",
        "authorized_official_last_name": "GIANNOPOULOS",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_title_or_position": "PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "414-331-8167",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "WI",
            "license": "7779-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100016425",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenfield, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2014; 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.