Myles D Tonnacliff, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

2163-057 Issued in WI

Practice address

W62N248 Washington Ave Ste 208
Cedarburg, WI 53012-2768

Phone

(262) 618-2856

NPI assigned

Feb 23, 2007

Last updated

Mar 10, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

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

Specialty

Clinical Psychologist

Education

Other, 1996

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Myles Tonnacliff PH.D, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Cedarburg, WI
  • NPI 1235666017
  Medicare reassignment Authorized official
• Wisconsin Lutheran Child & Family Services, Inc

  dba Christian Family Counseling

  • Adolescent and Children Mental Health Clinic/Center
  • Brookfield, WI
  • NPI 1194961474

  Professional

  NPD (past)
• Wisconsin Lutheran Child and Family Service Inc

  dba Christian Family Solutions

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Germantown, WI
  • NPI 1083786628

  Professional

  NPD (past)

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583798400000",
    "number": "1942335260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W62N248 WASHINGTON AVE STE 208",
            "city": "CEDARBURG",
            "state": "WI",
            "postal_code": "530122768",
            "telephone_number": "622-618-2856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W62N248 WASHINGTON AVE STE 208",
            "city": "CEDARBURG",
            "state": "WI",
            "postal_code": "530122768",
            "telephone_number": "262-618-2856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TONNACLIFF",
        "first_name": "MYLES",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-23",
        "last_updated": "2020-03-10",
        "certification_date": "2020-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "2282-125",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "2163-057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED PSYCHOLOGIST",
            "identifier": "2163-057",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39154700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Nakia Jean Toliber
• Neil Truckenbrod, DC
• Candice Truesdell Nokes, ED.S., NCSP
• Emily Valkenburgh, M.D.
• Michael Vineburg, PHARMD
• Christine Louisa Vollmer, LCSW

• Psychologist in Cedarburg, WI
• Providers in Cedarburg, WI by specialty
• Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.