John M O'Donnell, PH.D.

Primary specialty

Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X

License

561-057 Issued in WI

Practice address

5225 N Ironwood LN
Suite # 212
Glendale, WI 53217-4909

Phone

(414) 962-1000

NPI assigned

Mar 24, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1962462093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 LOFTY LN",
            "city": "SAUKVILLE",
            "state": "WI",
            "postal_code": "530802300",
            "telephone_number": "262-375-8653",
            "fax_number": "262-375-0722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5225 N IRONWOOD LN",
            "address_2": "SUITE # 212",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532174909",
            "telephone_number": "414-962-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'DONNELL",
        "first_name": "JOHN",
        "middle_name": "M",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "WI",
            "license": "561-057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39055600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Cognitive & Behavioral Psychologist in Glendale, WI
• Providers in Glendale, WI by specialty
• Cognitive & Behavioral Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.