Conrad Victor Christensen, PSYCHOLOGIST

Primary specialty

PsychologistTaxonomy code 103T00000X

License

289-57 Issued in WI

Practice address

10696 Park LN
Marshfield, WI 54449-9594

Phone

(715) 305-5113

Fax

(715) 223-1611

NPI assigned

Mar 10, 2014

Last updated

Mar 10, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Cadott Medical Center SC

  • Addiction Medicine (Family Medicine) Physician
  • Cadott, WI
  • NPI 1275691792
  NPD (past)

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

{
    "created_epoch": "1394409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394409600000",
    "number": "1659797009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10696 PARK LN",
            "city": "MARSHFIELD",
            "state": "WI",
            "postal_code": "544499594",
            "telephone_number": "715-305-5113",
            "fax_number": "715-223-1611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10696 PARK LN",
            "city": "MARSHFIELD",
            "state": "WI",
            "postal_code": "544499594",
            "telephone_number": "715-305-5113",
            "fax_number": "715-223-1611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTENSEN",
        "first_name": "CONRAD",
        "middle_name": "VICTOR",
        "credential": "PSYCHOLOGIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-03-10",
        "last_updated": "2014-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "289-57",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39064000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Child & Adolescent Psychiatry Consulting LLC (Empower Mental Health Clinic)
• Children's Service Society of Wisconsin
• Childrens Service Society
• Jodi Lynn Chojnacki, MS, LPC
• Joseph T Chojnacki, PHD
• Camryn Shelley Christopherson
• Wendy Chryst, ICSW
• Dominic S Chu, MD
• City of Marshfield (Marshfield Fire & Rescue)
• Emily A Ciula, DO

• Psychologist in Marshfield, WI
• Providers in Marshfield, WI by specialty
• Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2014; 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.