Milwaukee Mind Solutions

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

MILWAUKEE MIND SOLUTIONS

Practice address

3970 N Oakland Ave
Shorewood, WI 53211-2265

Phone

(224) 723-5050

Fax

(224) 723-5289

NPI assigned

Dec 20, 2019

Last updated

Dec 20, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Prachi Apostolos

Title

Clinic Manager

Phone

(224) 723-5050

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1576800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576800000000",
    "number": "1801434899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3970 N OAKLAND AVE",
            "city": "SHOREWOOD",
            "state": "WI",
            "postal_code": "532112265",
            "telephone_number": "224-723-5050",
            "fax_number": "224-723-5289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3970 N OAKLAND AVE",
            "city": "SHOREWOOD",
            "state": "WI",
            "postal_code": "532112265",
            "telephone_number": "224-723-5050",
            "fax_number": "224-723-5289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILWAUKEE MIND SOLUTIONS",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-20",
        "last_updated": "2019-12-20",
        "certification_date": "2019-12-20",
        "status": "A",
        "authorized_official_last_name": "APOSTOLOS",
        "authorized_official_first_name": "PRACHI",
        "authorized_official_title_or_position": "CLINIC MANAGER",
        "authorized_official_telephone_number": "224-723-5050",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIVATE INSURANCE",
            "identifier": "3169-57",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Shorewood, WI
• Providers in Shorewood, WI by specialty
• Clinical Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2019; 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.