Active NPI
Jacques-Rene Hebert, PSYD
- Clinical Psychologist
- Tomah, WI
National Provider Identifier
1871200063
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 4109-57
- Practice address
- 500 E Veterans St RM 1455
Tomah, WI 54660-3105 - Phone
- (608) 372-1761
- NPI assigned
- Oct 28, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 4109-57 | WI | Primary |
Addresses
Primary practice location
500 E Veterans St RM 1455
Tomah, WI 54660-3105
Mailing address
215 Pearl St Apt 1
La Crosse, WI 54601-3328
Phone (312) 813-9333
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4109-57 | WI | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1666915200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666915200000",
"number": "1871200063",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "215 PEARL ST APT 1",
"city": "LA CROSSE",
"state": "WI",
"postal_code": "546013328",
"telephone_number": "312-813-9333"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 E VETERANS ST RM 1455",
"city": "TOMAH",
"state": "WI",
"postal_code": "546603105",
"telephone_number": "608-372-1761"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEBERT",
"first_name": "JACQUES-RENE",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-10-28",
"last_updated": "2022-10-28",
"certification_date": "2022-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WI",
"license": "4109-57",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tomah, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.