Organization Active NPI

Synergy Group of Eau Claire SC

  • Counseling Psychologist
  • Eau Claire, WI
National Provider Identifier
1568770535
Registry record updated Dec 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
2294-57 Issued in WI
Legal business name
SYNERGY GROUP OF EAU CLAIRE SC
Practice address
2005 Highland Ave
Eau Claire, WI 54701-4455
Phone
(715) 834-3171
Fax
(715) 834-3174
NPI assigned
Sep 23, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2013

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

Authorized official

Name
Mark Bjerke, PHD
Title
Licensed Psychologist
Phone
(715) 834-3171

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC1900X 2294-57 WI Primary

Addresses

Primary practice location

2005 Highland Ave
Eau Claire, WI 54701-4455

Mailing address

2005 Highland Ave
Eau Claire, WI 54701-4455
Phone (715) 834-3171

Other names 1

  • Vantage Point Clinic & Assessment Center Doing business as

National Provider Directory

National Provider Directory

Locations

826 S Hastings Way
Eau Claire, WI 54701
Phone (715) 834-3171

NPI Registry JSON

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

{
    "created_epoch": "1285200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1387497600000",
    "number": "1568770535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2005 HIGHLAND AVE",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547014455",
            "telephone_number": "715-834-3171",
            "fax_number": "715-834-3174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 HIGHLAND AVE",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547014455",
            "telephone_number": "715-834-3171",
            "fax_number": "715-834-3174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYNERGY GROUP OF EAU CLAIRE SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-23",
        "last_updated": "2013-12-20",
        "status": "A",
        "authorized_official_last_name": "BJERKE",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "LICENSED PSYCHOLOGIST",
        "authorized_official_telephone_number": "715-834-3171",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Counseling",
            "state": "WI",
            "license": "2294-57",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vantage Point Clinic & Assessment Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eau Claire, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2013; 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.