Active NPI
Paul Joseph Dupont, PHD
- Psychologist
- Glendale, WI
National Provider Identifier
1497867170
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 1840057
- Practice address
- 5225 N Ironwood Rd
Ste 102 Stress Management & MHC
Glendale, WI 53217 - Phone
- (414) 962-9156
- Fax
- (414) 962-4356
- NPI assigned
- Aug 31, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 1840057 | WI | Primary |
Addresses
Primary practice location
5225 N Ironwood Rd
Ste 102 Stress Management & MHC
Glendale, WI 53217
Mailing address
5225 N Ironwood Rd
Ste 102
Glendale, WI 53217
Phone (414) 962-9156
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 39109700 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1840057 | WI | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Stress Management & Mental Health Clinics Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- West Allis, WI
- NPI 1003928391
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1497867170",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5225 N IRONWOOD RD",
"address_2": "STE 102",
"city": "GLENDALE",
"state": "WI",
"postal_code": "53217",
"telephone_number": "414-962-9156",
"fax_number": "414-962-4356"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5225 N IRONWOOD RD",
"address_2": "STE 102 STRESS MANAGEMENT & MHC",
"city": "GLENDALE",
"state": "WI",
"postal_code": "53217",
"telephone_number": "414-962-9156",
"fax_number": "414-962-4356"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUPONT",
"first_name": "PAUL",
"middle_name": "JOSEPH",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "WI",
"license": "1840057",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "39109700",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Glendale, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.