Individual provider Active NPI

Craig L Abrams, PHD

  • Psychologist
  • Sheboygan, WI
National Provider Identifier
1750367116
Registry record updated Nov 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
2110057 Issued in WI
Practice address
615 S 8TH St
Ste G20
Sheboygan, WI 53081-4405
Phone
(920) 457-8866
Fax
(920) 457-8867
NPI assigned
Dec 19, 2005
Last updated
Nov 16, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 2110057 WI Primary

Addresses

Primary practice location

615 S 8TH St
Ste G20
Sheboygan, WI 53081-4405

Mailing address

615 S 8TH St
Ste G20
Sheboygan, WI 53081-4405
Phone (920) 457-8866

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050811000444 WI Practitioner - Clinical Psychologist 5496784225 Reassigns benefits to 1 organization
Practice locations: Mequon, WI

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Life Point Counseling LLCGroup PAC ID 1254740525, 5 clinicians

Practice addresses (Care Compare)

2209 Eastern Ave
Plymouth, WI 53073-4281
Phone (920) 892-7606

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
2110057WIMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Life Point Counseling, LLC CurrentSince May 17, 2021 Accepting new patients
Northshore Clinic of Sheboygan Inc Past Accepting new patients
North Shore Center LLC Past Accepting new patients

Locations

2209 Eastern Ave
Plymouth, WI 53073
Phone (920) 449-4247

805 N 6th St
Sheboygan, WI 53081
Phone (920) 457-8866

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1134950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321401600000",
    "number": "1750367116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 S 8TH ST",
            "address_2": "STE G20",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530814405",
            "telephone_number": "920-457-8866",
            "fax_number": "920-457-8867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 S 8TH ST",
            "address_2": "STE G20",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530814405",
            "telephone_number": "920-457-8866",
            "fax_number": "920-457-8867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABRAMS",
        "first_name": "CRAIG",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-19",
        "last_updated": "2011-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "2110057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sheboygan, WI

Sources for this page

Verify at the official NPI Registry.