Kurt Charles Euller, PH.D.
Individual provider Active NPI Clinical Psychologist · Sparta, WI
NPI 1497797773 · NPPES record last updated May 18, 2009
Key facts
- NPI
- 1497797773
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 1190-057 (WI)
- Practice address
- 9533 Gavel Ave
Sparta, WI 54656-4528 - Phone
- (608) 751-3642
- Fax
- (608) 269-2642
- NPI assigned
- Jun 12, 2006
- 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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1190-057 | WI | MD | Clinical Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 1190-057 | WI | Yes |
Addresses
Primary practice location
9533 Gavel Ave
Sparta, WI 54656-4528
Mailing address
9533 Gavel Ave
Sparta, WI 54656-4528
Phone (608) 751-3642
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 39041000 | Medicaid | WI |
Other providers in Sparta, WI
- Richard Mark Edwards
- Mary Ehrhardt
- Nicholas W Ekern
- Matthew J Englerth
- Theresa Ertl
- Evergreen Manor II
- Evergreen Manor III, Inc
- Evergreen Manor,Inc.
- Amanda J Falkers
- Family & Childrens Center
All providers in Sparta, WI · Clinical 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 18, 2009. 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.