NPIMap

Organization Active NPI

Psychiatric Consultants & Therapists, SC

  • Psychologist
  • Milwaukee, WI
National Provider Identifier
1700818119
Registry record updated Sep 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
PSYCHIATRIC CONSULTANTS & THERAPISTS, SC
Practice address
229 E Wisconsin Ave
Suite 600
Milwaukee, WI 53202-4230
Phone
(414) 224-3737
Fax
(414) 224-3725
NPI assigned
Jul 7, 2006
Last updated
Sep 1, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2016

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

Authorized official

Name
Mary Jo CaminitiNPI 1760415160
Title
Clinic Manager
Phone
(414) 224-3737

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X NU Primary

Addresses

Primary practice location

229 E Wisconsin Ave
Suite 600
Milwaukee, WI 53202-4230

Mailing address

229 E Wisconsin Ave
Suite 600
Milwaukee, WI 53202-4230
Phone (414) 224-3737

Other identifiers 1

IdentifierTypeStateIssuer
42197700MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050929000204 WI Part B Supplier - Clinic/Group Practice 5092740985 Receives reassigned benefits from 21 practitioners
Practice locations: Milwaukee, WI

National Provider Directory

National Provider Directory

Locations

2015 E Newport Ave
Ste 411
Milwaukee, WI 53211
Phone (414) 224-3737

229 E Wisconsin Ave
Ste 60
Milwaukee, WI 53202
Phone (414) 224-3737

229 E Wisconsin Ave
Ste 600
Milwaukee, WI 53202
Phone (414) 224-3737

Practitioners & affiliated clinicians

Practitioners 34

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.

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472688000000",
    "number": "1700818119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "229 E WISCONSIN AVE",
            "address_2": "SUITE 600",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532024230",
            "telephone_number": "414-224-3737",
            "fax_number": "414-224-3725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "229 E WISCONSIN AVE",
            "address_2": "SUITE 600",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532024230",
            "telephone_number": "414-224-3737",
            "fax_number": "414-224-3725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHIATRIC CONSULTANTS & THERAPISTS, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2016-09-01",
        "status": "A",
        "authorized_official_last_name": "CAMINITI",
        "authorized_official_first_name": "MARY JO",
        "authorized_official_title_or_position": "CLINIC MANAGER",
        "authorized_official_telephone_number": "414-224-3737"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42197700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2016; 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.