Tanya Marie Novotnak, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

5192 Issued in WI

Practice address

4785 Hayes Rd Ste 100
Madison, WI 53704-7364

Phone

(608) 242-7160

NPI assigned

Jun 22, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Counseling Resources Neuropsychological Associates, LLC

  • Psychologist
  • Madison, WI
  • NPI 1932145430

  Clinical

  NPD
• Journey Mental Health Center, Inc.

  • Case Management Agency
  • Madison, WI
  • NPI 1841413879
  NPD (past)

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

{
    "created_epoch": "1624320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724976000000",
    "number": "1417526641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4785 HAYES RD STE 100",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537047364",
            "telephone_number": "608-242-7160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4785 HAYES RD STE 100",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537047364",
            "telephone_number": "608-242-7160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOVOTNAK",
        "first_name": "TANYA",
        "middle_name": "MARIE",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-22",
        "last_updated": "2024-08-30",
        "certification_date": "2024-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WI",
            "license": "5192",
            "primary": true
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "WI",
            "license": "857723",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gladys Elaine Novak, MSOM
• Laura Novak, LMT
• Sydney Novak, PHARMD
• Novamed Surgery Center of Madison, Limited Partnership
• Logan Novom, SLP
• Melissa Marie Novotny, DNP, APNP
• Mark Nowacki
• Beata Malgorzata Nowak, PHARMD
• Bethann Nowak, APNP
• Jessica Ann Nowak, APNP

• Clinical Psychologist in Madison, WI
• Providers in Madison, WI by specialty
• Clinical Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2024; 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.