Academic & Family Services, LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

745-057 Issued in WI

Legal business name

ACADEMIC & FAMILY SERVICES, LLC

Practice address

9120 W Hampton Ave
Suite 119
Milwaukee, WI 53225-4960

Phone

(262) 783-7778

Fax

(414) 464-9510

NPI assigned

Jul 23, 2007

Last updated

Jul 23, 2007By 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

Dr. Ellen G. Stern, PH.D.NPI 1124244363

Title

Owner

Phone

(262) 783-7778

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ellen G. Stern, PH.D.

  • Psychologist
  • Milwaukee, WI
  • NPI 1124244363
  NPD (past) Authorized official

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

{
    "created_epoch": "1185148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185148800000",
    "number": "1841490364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9120 W HAMPTON AVE",
            "address_2": "SUITE 119",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532254960",
            "telephone_number": "262-783-7778",
            "fax_number": "414-464-9510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9120 W HAMPTON AVE",
            "address_2": "SUITE 119",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532254960",
            "telephone_number": "262-783-7778",
            "fax_number": "414-464-9510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACADEMIC & FAMILY SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-23",
        "last_updated": "2007-07-23",
        "status": "A",
        "authorized_official_last_name": "STERN",
        "authorized_official_first_name": "ELLEN",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "262-783-7778",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WI",
            "license": "745-057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39015500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Milwaukee, WI
• Providers in Milwaukee, 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 23, 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.