Wisconsin Psychology Associates, LLC

Primary specialty

Health Service PsychologistTaxonomy code 103TH0100X

Legal business name

WISCONSIN PSYCHOLOGY ASSOCIATES, LLC

Practice address

318 Margaret CT
Burlington, WI 53105-2330

Phone

(812) 201-3912

NPI assigned

Jan 6, 2022

Last updated

Feb 9, 2022By 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

Dr. Rosita Fernandez, PSYDNPI 1376062851

Title

Owner/Psychologist

Phone

(812) 201-3912

Specialties & licenses 2

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Tax ID family

Wisconsin Psychology Associates LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Wisconsin Psychology Associates, LLC

  • Health Service Psychologist
  • Burlington, WI
  • NPI 1427709351
  NPD tax ID

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.

• Rosita M Fernandez

  • Psychologist
  • Burlington, WI
  • NPI 1376062851
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1641427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644364800000",
    "number": "1639830151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "318 MARGARET CT",
            "city": "BURLINGTON",
            "state": "WI",
            "postal_code": "531052330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "318 MARGARET CT",
            "city": "BURLINGTON",
            "state": "WI",
            "postal_code": "531052330",
            "telephone_number": "812-201-3912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISCONSIN PSYCHOLOGY ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-06",
        "last_updated": "2022-02-09",
        "certification_date": "2022-02-09",
        "status": "A",
        "authorized_official_last_name": "FERNANDEZ",
        "authorized_official_first_name": "ROSITA",
        "authorized_official_title_or_position": "OWNER/PSYCHOLOGIST",
        "authorized_official_telephone_number": "812-201-3912",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300007198IN",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1376062851",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://rose-fernandez.clientsecure.me/",
            "affiliation": "N",
            "endpointDescription": "Professional Website/Portal",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "318 Margaret Ct",
            "city": "Burlington",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531052330",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Angela Wingo
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• Wisconsin Vision Associates
• David Francis Wolff, PSYCHOLOGIST
• WP-Arc Arbor View Holdings LLC (Arbor View Communities)
• Brenda Wright, PT
• Daniel Joseph Wright, MS, PA-C

• Health Service Psychologist in Burlington, WI
• Providers in Burlington, WI by specialty
• Health Service Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.