Active NPI
Jeanne Marie Behrend, PHD
- Cognitive & Behavioral Psychologist
- Madison, WI
National Provider Identifier
1962574665
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cognitive & Behavioral Psychologist
- License
- 1113057
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 50639 | Other | NATIONAL REGISTER OF HEAL | |
| 39034400 | Medicaid | WI |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1113057 | WI | MD | Cognitive & 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.