Providence Psychiatric Services S C

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

PROVIDENCE PSYCHIATRIC SERVICES S C

Practice address

333 Bishops Way Ste 102
Brookfield, WI 53005-6209

Phone

(414) 239-3172

NPI assigned

Jun 4, 2022

Organization subpart

No

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

Authorized official

Name

Mary L Pintarro, APNP

Title

President

Phone

(414) 239-3172

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1654300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654300800000",
    "number": "1376272500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 BISHOPS WAY STE 102",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530056209",
            "telephone_number": "414-239-3172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 BISHOPS WAY STE 102",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530056209",
            "telephone_number": "414-239-3172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE PSYCHIATRIC SERVICES S C",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-04",
        "last_updated": "2022-06-04",
        "certification_date": "2022-06-04",
        "status": "A",
        "authorized_official_last_name": "PINTARRO",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "414-239-3172",
        "authorized_official_credential": "APNP"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatry Physician in Brookfield, WI
• Providers in Brookfield, WI by specialty
• Psychiatry Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2022; 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.