Alison Gorman, PSYD
Individual provider Active NPI Clinical Psychologist · Prairie Du Sac, WI
NPI 1750144960 · NPPES record last updated May 30, 2025
Key facts
- NPI
- 1750144960
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 5088-57 (WI)
- Practice address
- 260 26TH St
Prairie Du Sac, WI 53578-2203 - Phone
- (608) 643-3311
- NPI assigned
- Jan 31, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 10
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Sauk Prairie Healthcare Inc
Practice addresses (Care Compare)
436 Sunrise Dr
Spring Green, WI 53588-9286
Phone (608) 588-2502
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 |
|---|---|---|---|---|
| I20251112001640 | WI | Practitioner - Clinical Psychologist | 3375034937 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5088-57 | WI | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sauk Prairie Healthcare Inc | Current | Accepting new patients | |
| Sauk Prairie Healthcare, Inc. | Current |
Accepting new patients | |
| Sauk Prairie Healthcare Inc | Current | Accepting new patients | |
| Sauk Prairie Healthcare Inc | Current |
Accepting new patients |
Locations
160 Valley Dr
Lodi, WI 53555
Phone (608) 592-3296
506 Crocker St
Ste 3
Mazomanie, WI 53560
Phone (608) 795-4110
825 Main St
Plain, WI 53577
Phone (608) 546-4211
260 26th St
Prairie du Sac, WI 53578
Phone (608) 643-2471
436 Sunrise Dr
Spring Green, WI 53588
Phone (608) 588-2502
Interoperability endpoints
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health Psychologist | 103TH0004X | 5088-57 | WI | |
| Clinical Psychologist | 103TC0700X | 5088-57 | WI | Yes |
Addresses
Primary practice location
260 26TH St
Prairie Du Sac, WI 53578-2203
Mailing address
260 26TH St
Prairie Du Sac, WI 53578-2203
Other providers in Prairie Du Sac, WI
- Brenda Kay Fronsee
- Sarah May Frosch
- Teryl J Frosch
- Paul J Ganshert
- Laura Genthe
- Melissa M Graf
- Nathan D Grunewald
- Michael L Hammer
- Katherine Haugen
- Matthew M Hebert
All providers in Prairie Du Sac, WI · Clinical 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 May 30, 2025. 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.