Larry Kevin Hamberger, PHD

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

1004 Issued in WI

Practice address

2400 W Villard Ave
WFHC Glendale Family Center
Milwaukee, WI 53209-4901

Phone

(414) 527-8458

Fax

(414) 527-8045

NPI assigned

May 15, 2006

Sex

Male

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 2

Other names 1

• Mr. L Kevin Hamberger Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358985600000",
    "number": "1780635524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 W VILLARD AVE",
            "address_2": "WFHC GLENDALE FAMILY CENTER",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532094901",
            "telephone_number": "414-527-8458",
            "fax_number": "414-527-8045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 W VILLARD AVE",
            "address_2": "WFHC GLENDALE FAMILY CENTER",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532094901",
            "telephone_number": "414-527-8458",
            "fax_number": "414-527-8045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMBERGER",
        "first_name": "LARRY",
        "middle_name": "KEVIN",
        "name_prefix": "Mr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-15",
        "last_updated": "2013-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "WI",
            "license": "1004",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "002000119L",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1780635524",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "L",
            "last_name": "HAMBERGER",
            "middle_name": "KEVIN",
            "prefix": "MR.",
            "credential": "PHD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Gloria H Halverson, MD
• Paul B Halverson, MD
• Bushra Hamad
• Sayed Mehdi Hussain Hamadani, M.D
• Duhah Hamayel, MD
• Sarah M Hambrook, MD
• Mohammed Hamdan
• Moaz Hamed, M.D.
• Raed A Hamed, MD
• Ifrah Hameed

• Clinical Child & Adolescent Psychologist in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Clinical Child & Adolescent Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2013; 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.