NPIMap

Organization Active NPI

County of Milwaukee

  • Psychologist
  • Milwaukee, WI
National Provider Identifier
1942362066
Registry record updated Apr 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
COUNTY OF MILWAUKEE
Practice address
1220 W Vliet St FL 3
Milwaukee, WI 53205-2117
Phone
(414) 257-6995
NPI assigned
Dec 14, 2006
Last updated
Apr 13, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2023

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

Authorized official

Name
Sheri Duquaine
Title
Patient Accounts Manager
Phone
(414) 391-8172

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X WI Primary

Addresses

Primary practice location

1220 W Vliet St FL 3
Milwaukee, WI 53205-2117

Mailing address

1220 W Vliet St FL 3
Milwaukee, WI 53205-2117
Phone (414) 257-6995

Other identifiers 2

IdentifierTypeStateIssuer
43551200MedicaidWI
000000812OtherWIMEDICARE PTAN

Other names 1

  • Milwaukee County Behavioral Health Psychological Associates Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031104000139 WI Part B Supplier - Clinic/Group Practice 0446162887 Receives reassigned benefits from 12 practitioners
1 other NPI on this enrollment
Practice locations: Milwaukee, WI

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
County of Milwaukee15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

Locations

1220 W Vliet St
Ste 302
Milwaukee, WI 53205

9455 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 257-6310

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Mental Health Emergency Center, Inc.Milwaukee, WI, CCN 524044 Hospital 5% Or Greater Direct Ownership Interest (50%) May 25, 2022

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681344000000",
    "number": "1942362066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 W VLIET ST FL 3",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532052117",
            "telephone_number": "414-257-6995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 W VLIET ST FL 3",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532052117",
            "telephone_number": "414-257-6995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF MILWAUKEE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-14",
        "last_updated": "2023-04-13",
        "certification_date": "2023-04-13",
        "status": "A",
        "authorized_official_last_name": "DUQUAINE",
        "authorized_official_first_name": "SHERI",
        "authorized_official_title_or_position": "PATIENT ACCOUNTS MANAGER",
        "authorized_official_telephone_number": "414-391-8172"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43551200",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "000000812",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Milwaukee County Behavioral Health Psychological Associates",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Milwaukee County Behavioral Health Psychological Associates",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.