Mindy Elizabeth Haseleu, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

2519057 Issued in WI

Practice address

705 W Main St Ste 3
Sun Prairie, WI 53590-2849

Phone

(608) 825-6663

Fax

(608) 825-6946

NPI assigned

Aug 3, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 6

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

Specialty

Clinical Psychologist

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Sun Prairie Psychological LLC

  • Clinical Psychologist
  • Sun Prairie, WI
  • NPI 1316766082
  Medicare reassignment NPD Authorized official
• Family Resources Associates Inc

  • Mental Health Counselor
  • Jefferson, WI
  • NPI 1497960645
  NPD (past)

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373414400000",
    "number": "1760490205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 W MAIN ST STE 3",
            "city": "SUN PRAIRIE",
            "state": "WI",
            "postal_code": "535902849",
            "telephone_number": "608-825-6663",
            "fax_number": "608-825-6946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 W MAIN ST STE 3",
            "city": "SUN PRAIRIE",
            "state": "WI",
            "postal_code": "535902849",
            "telephone_number": "608-825-6663",
            "fax_number": "608-825-6946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASELEU",
        "first_name": "MINDY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-03",
        "last_updated": "2013-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WI",
            "license": "2519057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEAN INS",
            "identifier": "13664",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITY INSURANCE WATERTOWN",
            "identifier": "39184249622",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITY INS LAKE MILLS",
            "identifier": "39184249623",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIANS PLUS INS",
            "identifier": "2004452",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40976400",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN INSURANCE",
            "identifier": "348589",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Tara Harris, OTD, OTR/L
• Tasha Harris
• Harvest Chiropractic LLC
• Mahwish Hashmi
• Stephanie W Haugen, LPC
• Lisa Hawn, RN
• HBL Therapy Center, LLC
• Healbridge Solutions LLC

• Clinical Psychologist in Sun Prairie, WI
• Providers in Sun Prairie, WI by specialty
• Clinical Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.