Individual provider Active NPI

Susan Marie Steinbrueck, PH.D.

  • Psychologist
  • Mount Pleasant, WI
National Provider Identifier
1851515233
Registry record updated Jan 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
1703-057 Issued in WI
Practice address
5605 Washington Ave Ste 8F
Mt Pleasant, WI 53406-4056
Phone
(262) 977-0088
Fax
(262) 753-6821
NPI assigned
Apr 13, 2007
Last updated
Jan 2, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 1703-057 WI Primary

Addresses

Primary practice location

5605 Washington Ave Ste 8F
Mt Pleasant, WI 53406-4056

Mailing address

5605 Washington Ave Ste 8F
Mt Pleasant, WI 53406-4056
Phone (262) 977-0088

Other identifiers 2

IdentifierTypeStateIssuer
11808707OtherCAQH
1703OtherWILICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071214000723 WI Practitioner - Clinical Psychologist 6204926181 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5605 Washington Ave
Mt Pleasant, WI 53406-4056
Phone (262) 977-0088

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1703-057WIMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Steinbrueck Psychological Services LLC Psychologist CurrentSince Apr 17, 2019 Accepting new patients
Visiting Nurse Association of Wisconsin, Inc. Past Accepting new patients

Locations

5605 Washington Ave
Ste 8F
Mount Pleasant, WI 53406
Phone (262) 822-4844

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577923200000",
    "number": "1851515233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5605 WASHINGTON AVE STE 8F",
            "city": "MT PLEASANT",
            "state": "WI",
            "postal_code": "534064056",
            "telephone_number": "262-977-0088",
            "fax_number": "262-753-6821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5605 WASHINGTON AVE STE 8F",
            "city": "MT PLEASANT",
            "state": "WI",
            "postal_code": "534064056",
            "telephone_number": "262-977-0088",
            "fax_number": "262-753-6821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEINBRUECK",
        "first_name": "SUSAN",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-13",
        "last_updated": "2020-01-02",
        "certification_date": "2020-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "1703-057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11808707",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "1703",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Pleasant, WI

Sources for this page

Verify at the official NPI Registry.