Eau Claire Psychologists LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1783-57 Issued in WI

Legal business name

EAU CLAIRE PSYCHOLOGISTS LLC

Practice address

101 N Farwell St
Ste. 204
Eau Claire, WI 54703-3765

Phone

(715) 514-4600

Fax

(715) 514-4008

NPI assigned

Oct 25, 2016

Last updated

Dec 27, 2016By 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

Anton C Smets, PH.D., PSY.D.NPI 1861458093

Title

Partner

Phone

(715) 514-4600

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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.

• Anton C Smets, PHD PSYD

  • Clinical Child & Adolescent Psychologist
  • Eau Claire, WI
  • NPI 1861458093
  Authorized official Same address or phone

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

{
    "created_epoch": "1477353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482796800000",
    "number": "1528510633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 N FARWELL ST",
            "address_2": "STE. 204",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547033765",
            "telephone_number": "715-514-4600",
            "fax_number": "715-514-4008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 N FARWELL ST",
            "address_2": "STE. 204",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547033765",
            "telephone_number": "715-514-4600",
            "fax_number": "715-514-4008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAU CLAIRE PSYCHOLOGISTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-25",
        "last_updated": "2016-12-27",
        "status": "A",
        "authorized_official_last_name": "SMETS",
        "authorized_official_first_name": "ANTON",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "715-514-4600",
        "authorized_official_credential": "PH.D., PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "WI",
            "license": "1783-57",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39230200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Eau Claire, WI
• Providers in Eau Claire, WI by specialty
• Clinical Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2016; 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.