Wisconsin Psychological Center

Primary specialty

PsychologistTaxonomy code 103T00000X

License

2648 Issued in WI

Legal business name

WISCONSIN PSYCHOLOGICAL CENTER

Practice address

49 Kessel CT
Suite 204
Madison, WI 53711-6275

Phone

(608) 270-1800

Fax

(608) 270-9731

NPI assigned

Jun 26, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Marcelo Trinidad-Carrillo, PH.D.NPI 1205889151

Title

Psychologist

Phone

(608) 270-1800

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Marcelo Trinidad-Carrillo, PH.D.

  • Psychologist
  • Fitchburg, WI
  • NPI 1205889151
  NPD (past) Authorized official

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

{
    "created_epoch": "1182816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213747200000",
    "number": "1346446259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 930406",
            "city": "VERONA",
            "state": "WI",
            "postal_code": "535930406",
            "telephone_number": "608-270-1800",
            "fax_number": "608-270-9731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 KESSEL CT",
            "address_2": "SUITE 204",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537116275",
            "telephone_number": "608-270-1800",
            "fax_number": "608-270-9731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISCONSIN PSYCHOLOGICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-26",
        "last_updated": "2008-06-18",
        "status": "A",
        "authorized_official_last_name": "TRINIDAD-CARRILLO",
        "authorized_official_first_name": "MARCELO",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "608-270-1800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "WI",
            "license": "2648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• 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 Jun 18, 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.

Verify at the official NPI Registry.