Edward J Donner, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

2142057 Issued in WI

Practice address

3601 30TH Ave
Suite LL1
Kenosha, WI 53144-1695

Phone

(262) 657-9777

Fax

(262) 657-9785

NPI assigned

May 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 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Philosophy

State licenses

Practice roles

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

• Alliance Psychological and Family Services LLC

  • Clinical Psychologist
  • Kenosha, WI
  • NPI 1750314159
  NPD (past) Authorized official

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191628800000",
    "number": "1710936141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 30TH AVE",
            "address_2": "SUITE LL1",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531441695",
            "telephone_number": "262-657-9777",
            "fax_number": "262-657-9785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 30TH AVE",
            "address_2": "SUITE LL1",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531441695",
            "telephone_number": "262-657-9777",
            "fax_number": "262-657-9785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONNER",
        "first_name": "EDWARD",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2007-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WI",
            "license": "2142057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39755100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tobias Doherty, PHARMD
• Madelyn Elizabeth Dokken
• Andrea Domina, PT
• Kathleen Donkor, RN
• Donlee Health and Wellness LLC
• Peyton Donofrio, RDN
• Myriam Jacynthe Donovitch, M.D
• Jessica L Dorner, LPC
• Sarah Ann Dosemagen, PTA
• Cina Zsonvielle Douglas, PTA

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 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.