Tracey E Latza, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

3102-57 Issued in WI

Practice address

12760 W North Ave
Building a
Brookfield, WI 53005-4628

Phone

(262) 439-5500

Fax

(866) 439-5221

NPI assigned

Aug 23, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• Milwaukee Psychiatric Physicians Chartered

  • Psychiatry Physician
  • Brookfield, WI
  • NPI 1588739155
  NPD (past)

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642464000000",
    "number": "1760599211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12760 W NORTH AVE",
            "address_2": "BUILDING A",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530054628",
            "telephone_number": "262-439-5500",
            "fax_number": "866-439-5221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12760 W NORTH AVE",
            "address_2": "BUILDING A",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530054628",
            "telephone_number": "262-439-5500",
            "fax_number": "866-439-5221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATZA",
        "first_name": "TRACEY",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-23",
        "last_updated": "2022-01-18",
        "certification_date": "2022-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WI",
            "license": "3601-125",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "3102-57",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sergiy Larin, MD
• Luz Daniela Larraga Martinez, DPT
• Lesley Larsen Kountz, COTA
• Jaime Larsen, MS, MA
• David Laska, PTA
• Jill Janine Lau
• Tracy Laubenstein
• Timothy Laughlin
• Amy M Lautz, M.D.
• Judy Lauwasser Bruett, LCSW

• Psychologist in Brookfield, WI
• Providers in Brookfield, WI by specialty
• Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2022; 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.