Steven Robert Clothier, M.S.E.
Individual provider Active NPI School Psychologist · Menasha, WI
NPI 1437418985 · NPPES record last updated May 3, 2012
Key facts
- NPI
- 1437418985
- Entity type
- Individual (NPI type 1)
- Primary specialty
- School Psychologist 103TS0200X
- License
- 890-58 (WI)
- Practice address
- 1488 Kenwood Dr
Menasha, WI 54952-1152 - Phone
- (920) 883-9336
- NPI assigned
- May 3, 2012
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 890-58 | WI | MD | School Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 890-58 | WI | Yes |
Addresses
Primary practice location
1488 Kenwood Dr
Menasha, WI 54952-1152
Mailing address
1488 Kenwood Dr
Menasha, WI 54952-1152
Phone (920) 883-9336
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All providers in Menasha, WI · School Psychologist in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 3, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.