Active NPI
Psych Affiliates Inc
- Psychiatric/Mental Health Nurse Practitioner
- Mequon, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- Legal business name
- PSYCH AFFILIATES INC
- Practice address
- 11431 N Port Washington Rd Ste 101B
Mequon, WI 53092-3463 - Phone
- (414) 502-7216
- NPI assigned
- Mar 12, 2022
- Last updated
- Feb 5, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Dennis Lee Kochanik
- Title
- President
- Phone
- (414) 502-7216
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | |||
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | Primary |
Addresses
Primary practice location
11431 N Port Washington Rd Ste 101B
Mequon, WI 53092-3463
Mailing address
11431 N Port Washington Rd Ste 101B
Mequon, WI 53092-3463
Phone (267) 699-8834
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100190462 | Medicaid | WI |
National Provider Directory
National Provider DirectoryLocations
11431 N Port Washington Rd
Ste 101B
Mequon, WI 53092
Phone (267) 699-8834
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Psychiatric/Mental Health Nurse Practitioner
- Mequon, WI
- NPI 1982378493
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1647043200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1707091200000",
"number": "1417605197",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11431 N PORT WASHINGTON RD STE 101B",
"city": "MEQUON",
"state": "WI",
"postal_code": "530923463",
"telephone_number": "267-699-8834"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11431 N PORT WASHINGTON RD STE 101B",
"city": "MEQUON",
"state": "WI",
"postal_code": "530923463",
"telephone_number": "414-502-7216"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PSYCH AFFILIATES INC",
"organizational_subpart": "NO",
"enumeration_date": "2022-03-12",
"last_updated": "2024-02-05",
"certification_date": "2024-02-05",
"status": "A",
"authorized_official_last_name": "KOCHANIK",
"authorized_official_first_name": "DENNIS",
"authorized_official_middle_name": "LEE",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "414-502-7216",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner",
"state": null,
"license": null,
"primary": false
},
{
"code": "363LP0808X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100190462",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mequon, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 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.