Individual provider Active NPI

Jeanne Marie Behrend, PHD

  • Cognitive & Behavioral Psychologist
  • Madison, WI
National Provider Identifier
1962574665
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X
License
1113057 Issued in WI
Practice address
5610 Medical Circle
Suite 25
Madison, WI 53719-1295
Phone
(608) 274-5871
Fax
(608) 274-5764
NPI assigned
Nov 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cognitive & Behavioral Psychologist 103TB0200X 1113057 WI Primary

Addresses

Primary practice location

5610 Medical Circle
Suite 25
Madison, WI 53719-1295

Mailing address

850 Schuster Road
Sun Prairie, WI 53590-2437
Phone (608) 837-9700

Other identifiers 2

IdentifierTypeStateIssuer
50639OtherNATIONAL REGISTER OF HEAL
39034400MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Sep 12, 2023 through Sep 12, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1113057WIMDCognitive & Behavioral Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962574665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 SCHUSTER ROAD",
            "city": "SUN PRAIRIE",
            "state": "WI",
            "postal_code": "535902437",
            "telephone_number": "608-837-9700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5610 MEDICAL CIRCLE",
            "address_2": "SUITE 25",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537191295",
            "telephone_number": "608-274-5871",
            "fax_number": "608-274-5764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEHREND",
        "first_name": "JEANNE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "WI",
            "license": "1113057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL REGISTER OF HEAL",
            "identifier": "50639",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39034400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.