J T School District 2

Primary specialty

PsychologistTaxonomy code 103T00000X

License

079225 Issued in WI

Legal business name

J T SCHOOL DISTRICT 2

Doing business as

Village of White Lake & School District of White Lake

Practice address

405 Bissell Street
White Lake, WI 54491-0067

Phone

(715) 882-2361

Fax

(715) 882-2914

NPI assigned

May 14, 2008

Last updated

May 14, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Deborah Douglas Wall, MSE

Title

Dir of Special Education

Phone

(715) 882-2361

Specialties & licenses 3

Addresses

Other names 1

• Village of White Lake & School District of White Lake Doing business as

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

{
    "created_epoch": "1210723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210723200000",
    "number": "1467629907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 67",
            "address_2": "405 BISSELL STREET",
            "city": "WHITE LAKE",
            "state": "WI",
            "postal_code": "544910067",
            "telephone_number": "715-882-2361",
            "fax_number": "715-882-2914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 BISSELL STREET",
            "city": "WHITE LAKE",
            "state": "WI",
            "postal_code": "544910067",
            "telephone_number": "715-882-2361",
            "fax_number": "715-882-2914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J T SCHOOL DISTRICT 2",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-14",
        "last_updated": "2008-05-14",
        "status": "A",
        "authorized_official_last_name": "WALL",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "DOUGLAS",
        "authorized_official_title_or_position": "DIR OF SPECIAL EDUCATION",
        "authorized_official_telephone_number": "715-882-2361",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MSE"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "WI",
            "license": "605019",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "079225",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "065019",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Village of White Lake & School District of White Lake",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bonnie May Stegall, LPN
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• Psychologist in White Lake, WI
• Providers in White Lake, WI by specialty
• Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2008; 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.