NPIMap

Organization Active NPI

Elmbrook Family Counseling Center LLP

  • Clinical Psychologist
  • Brookfield, WI
National Provider Identifier
1831211309
Registry record updated Aug 29, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1297 Issued in WI
Legal business name
ELMBROOK FAMILY COUNSELING CENTER LLP
Practice address
12690 W North Ave
Brookfield, WI 53005-4636
Phone
(262) 785-9188
NPI assigned
Apr 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2007

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

Authorized official

Name
Dr. Howard J. Haven, PH.D.
Title
Director
Phone
(262) 785-9188

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X 1297 WI Primary

Addresses

Primary practice location

12690 W North Ave
Brookfield, WI 53005-4636

Mailing address

12690 W North Ave
Brookfield, WI 53005-4636
Phone (262) 785-9188

National Provider Directory

National Provider Directory

Locations

13000 W Bluemound Rd
Ste 300
Elm Grove, WI 53122
Phone 2627859188 ext. 26278

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188345600000",
    "number": "1831211309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12690 W NORTH AVE",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530054636",
            "telephone_number": "262-785-9188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12690 W NORTH AVE",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530054636",
            "telephone_number": "262-785-9188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELMBROOK FAMILY COUNSELING CENTER LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-04",
        "last_updated": "2007-08-29",
        "status": "A",
        "authorized_official_last_name": "HAVEN",
        "authorized_official_first_name": "HOWARD",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "262-785-9188",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "WI",
            "license": "1297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookfield, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2007; 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.