Individual provider Active NPI

Patricia Humphrey, PSY.D.

  • Clinical Psychologist
  • Madison, WI
National Provider Identifier
1750758033
Registry record updated Aug 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3295-57 Issued in WI
Practice address
4785 Hayes Rd Ste 100
Madison, WI 53704-7364
Phone
(608) 242-7160
NPI assigned
Aug 21, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 3295-57 WI Primary

Addresses

Primary practice location

4785 Hayes Rd Ste 100
Madison, WI 53704-7364

Mailing address

4785 Hayes Rd Ste 100
Madison, WI 53704-7364
Phone (608) 242-7160

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
I20150909000250 WI Practitioner - Clinical Psychologist 8628384583 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Counseling Resources Neuropsychological Associates, LLCGroup PAC ID 3577505510, 3 clinicians

Practice addresses (Care Compare)

4785 Hayes Rd
Suite 100
Madison, WI 53704-7364
Phone (608) 242-7160

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3295-57WIMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Counseling Resources Neuropsychological Associates, LLC Clinical CurrentSince Sep 7, 2015 Accepting new patients

Locations

4785 Hayes Rd
Ste 100
Madison, WI 53704
Phone 6082427160 ext. 1

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1440115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659571200000",
    "number": "1750758033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4785 HAYES RD STE 100",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537047364",
            "telephone_number": "608-242-7160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4785 HAYES RD STE 100",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537047364",
            "telephone_number": "608-242-7160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMPHREY",
        "first_name": "PATRICIA",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-21",
        "last_updated": "2022-08-04",
        "certification_date": "2022-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WI",
            "license": "3295-57",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.