David T Marx, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

3010-57 Issued in WI

Practice address

4536 22ND Ave
Kenosha, WI 53140-5917

Phone

(262) 656-0044

Fax

(262) 653-2218

NPI assigned

Jun 6, 2013

Last updated

Nov 13, 2013By 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 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1370476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384300800000",
    "number": "1407294937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 TROY DR",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537041521",
            "telephone_number": "608-301-1235",
            "fax_number": "608-301-1236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4536 22ND AVE",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531405917",
            "telephone_number": "262-656-0044",
            "fax_number": "262-653-2218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARX",
        "first_name": "DAVID",
        "middle_name": "T",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-06",
        "last_updated": "2013-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "3010-57",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "3010-57",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angela Maria Martin, MSW, LCSW
• Erin Martin, COTA
• Tyler Martin, MA, ATC, LAT
• Amanda A Martinez
• Jessica Martzahl, LPC
• Autumn Marzette-Anderson, LPC
• Molly Mason, CRNA
• Ann Mastrostefano, COTA
• Nicholas Masyga
• Rodrigo A Mata Jr., M.D.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2013; 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.