Individual provider Active NPI

David Anthony Songco, PSY.D.

  • Clinical Psychologist
  • Milwaukee, WI
National Provider Identifier
1881025864
Registry record updated Nov 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3241-57 Issued in WI
Practice address
1121 E North Ave
Milwaukee, WI 53212-3515
Phone
(414) 267-6502
Fax
(414) 267-3892
NPI assigned
Dec 2, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 3241-57 WI Primary

Addresses

Primary practice location

1121 E North Ave
Milwaukee, WI 53212-3515

Mailing address

1121 E North Ave
Milwaukee, WI 53212-3515
Phone (414) 267-6502

Other practice location 1

1845 N Farwell Ave
Suite 104
Milwaukee, WI 53202-1793
Phone (414) 604-6413

Other identifiers 1

IdentifierTypeStateIssuer
1881025864MedicaidWI

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
I20180329000674 WI Practitioner - Clinical Psychologist 7719249846 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

W180N8000 Town Hall Rd
Menomonee Falls, WI 53051-4002
Phone (262) 255-2500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3241-57WIMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Milwaukee Health Services, Inc. CurrentSince Sep 27, 2023 Accepting new patients
Outreach Community Health Centers, Inc. CurrentSince Jun 9, 2024 Accepting new patients
The Medical College of Wisconsin, Inc. CurrentSince Dec 1, 2021 Accepting new patients
Milwaukee Health Services Inc CurrentSince Sep 27, 2023 Accepting new patients
Outreach Community Health Centers, Inc CurrentSince Jun 9, 2024 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Jul 26, 2023 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Jul 26, 2023 Accepting new patients

Locations

W168N11237 Western Ave
Germantown, WI 53022
Phone (262) 253-5060

220 W Capitol Dr
Glendale, WI 53212
Phone (414) 964-9018

N74W12501 Leatherwood Ct
Menomonee Falls, WI 53051
Phone (414) 454-4744

W180N8000 Town Hall Rd
Menomonee Falls, WI 53051
Phone (262) 255-2500

2555 N Mlk Dr
Milwaukee, WI 53212
Phone (414) 267-2022

1121 E North Ave
Milwaukee, WI 53212
Phone (414) 267-6500

8200 W Silver Spring Dr
Milwaukee, WI 53218
Phone (414) 760-3900

9200 W Wisconsin Ave
Wauwatosa, WI 53226
Phone (414) 259-3000

8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100

1155 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 955-5990

Organizations & group practices 7

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

NPI Registry JSON

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

{
    "created_epoch": "1385942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637107200000",
    "number": "1881025864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1121 E NORTH AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532123515",
            "telephone_number": "414-267-6502",
            "fax_number": "414-267-3892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 E NORTH AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532123515",
            "telephone_number": "414-267-6502",
            "fax_number": "414-267-3892"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1845 N Farwell Ave",
            "address_2": "Suite 104",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532021793",
            "country_code": "US",
            "telephone_number": "414-604-6413",
            "fax_number": "888-977-5233",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SONGCO",
        "first_name": "DAVID",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-12-02",
        "last_updated": "2021-11-17",
        "certification_date": "2021-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WI",
            "license": "3241-57",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1881025864",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.