Maureen White, PH.D.
Individual provider Active NPI Counseling Psychologist · Gresham, WI
NPI 1679988083 · NPPES record last updated Jan 26, 2023
Key facts
- NPI
- 1679988083
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counseling Psychologist 103TC1900X
- Practice address
- N2150 Kesaehkahtek
Gresham, WI 54128-2150 - Phone
- (715) 799-3835
- Fax
- (715) 799-5056
- NPI assigned
- Jun 24, 2014
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Family Therapy Center of Madison, Inc.
Practice addresses (Care Compare)
700 Ray O Vac Dr
Suite 220
Madison, WI 53711-2476
Phone (608) 276-9191
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231127001607 | WI | Practitioner - Clinical Psychologist | 0446608897 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Therapy Center of Madison, Inc. | Current |
Accepting new patients | |
| Peter C. Jackson, PSYD Consulting, SC | Current |
Accepting new patients |
Locations
700 Ray O Vac Dr
Ste 220
Madison, WI 53711
Phone (608) 276-9191
10 E Doty St
Ste 445
Madison, WI 53703
Phone (608) 276-9191
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | Yes |
Addresses
Primary practice location
N2150 Kesaehkahtek
Gresham, WI 54128-2150
Mailing address
N2150 Kesaehkahtek
Gresham, WI 54128-2150
Phone (715) 799-3835
Other providers in Gresham, WI
- Maehnowesekiyah Wellness Center
- Jennifer Mavis
- Nanette Marie Pamonicutt
- Chantelle Panske
- Brandon Waupekenay
- Bruce A Wilber Jr.
- Jennifer A Wilber
All providers in Gresham, WI · Counseling Psychologist in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 26, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.