Gary James Loethen, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1914-057 Issued in WI

Practice address

500 E Veterans St
Tomah, WI 54660-3105

Phone

(608) 372-3971

Fax

(608) 372-1263

NPI assigned

Jun 10, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184198400000",
    "number": "1699717348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 E VETERANS ST",
            "city": "TOMAH",
            "state": "WI",
            "postal_code": "546603105",
            "telephone_number": "608-372-3971",
            "fax_number": "608-372-1263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 E VETERANS ST",
            "city": "TOMAH",
            "state": "WI",
            "postal_code": "546603105",
            "telephone_number": "608-372-3971",
            "fax_number": "608-372-1263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOETHEN",
        "first_name": "GARY",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-10",
        "last_updated": "2007-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WI",
            "license": "1914-057",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachael Linehan
• Sofia Linsenmeyer, M.S., CF-SLP
• Amy M Lisi, RN, BSN
• Ashley Erin Lisowski, RN
• Anna Little, PHARMD
• Kathleen R Loethen, M.S., C.R.C., L.P.C.
• Kara Rae Lorenz, RN
• Michelle Losby
• Brittany Lowen, OTR/L
• Angela Lowery, PH.D.

• Clinical Psychologist in Tomah, WI
• Providers in Tomah, WI by specialty
• Clinical Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2007; 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.