Mente Salus Psychological Services, LLC

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

2858-057 Issued in WI

Legal business name

MENTE SALUS PSYCHOLOGICAL SERVICES, LLC

Practice address

4319 Jeffers Rd
Suite 101
Eau Claire, WI 54703-3726

Phone

(715) 839-7240

Fax

(715) 839-7674

NPI assigned

Feb 28, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Nina Frances Albanese-Kotar, PHD

Title

Sole Member/Licensed Psychologist

Phone

(715) 839-7240

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1362009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362009600000",
    "number": "1699015636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4319 JEFFERS RD",
            "address_2": "SUITE 101",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547033726",
            "telephone_number": "715-839-7240",
            "fax_number": "715-839-7674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4319 JEFFERS RD",
            "address_2": "SUITE 101",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547033726",
            "telephone_number": "715-839-7240",
            "fax_number": "715-839-7674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENTE SALUS PSYCHOLOGICAL SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-28",
        "last_updated": "2013-02-28",
        "status": "A",
        "authorized_official_last_name": "ALBANESE-KOTAR",
        "authorized_official_first_name": "NINA",
        "authorized_official_middle_name": "FRANCES",
        "authorized_official_title_or_position": "SOLE MEMBER/LICENSED PSYCHOLOGIST",
        "authorized_official_telephone_number": "715-839-7240",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Counseling",
            "state": "WI",
            "license": "2858-057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1700105855",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI TYPE I",
            "identifier": "1700105855",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 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.