Lake Geneva Psychology, Inc.
Organization Active NPI Clinical Psychologist · Walworth, WI
NPI 1972124980 · NPPES record last updated Apr 30, 2020
Key facts
- NPI
- 1972124980
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Psychologist 103TC0700X
- Legal business name
- LAKE GENEVA PSYCHOLOGY, INC.
- Practice address
- 630 Kenosha St
Walworth, WI 53184-9505 - Phone
- (305) 989-9030
- NPI assigned
- Apr 30, 2020
- Organization subpart
- No
Authorized official
- Name
- Dr. Amy Sosa, PSY.D., CEDS
- Title
- Director/Owner
- Phone
- (305) 989-9030
Practitioners 1
-
Amy Sosa, PSY.D.
National Provider Directory
Locations
630 Kenosha St
Walworth, WI 53184
Phone (262) 949-7020
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist |
103TC0700X | Yes |
Addresses
Primary practice location
630 Kenosha St
Walworth, WI 53184-9505
Mailing address
N1330 Overland LN
Lake Geneva, WI 53147-7302
Phone (305) 989-9030
Other providers in Walworth, WI
- Samantha Golembiewski
- Megan R Hopp
- Dale Gary Jacobson
- Victoria Ann Knull
- Bridget Grace Labus
- McCullough Pharmacy Inc
- Michael C. Nice
- Catie Fern Pontel
- Powerback Rehabilitation LLC
- Daniel William Rankin
All providers in Walworth, WI · Clinical Psychologist in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 30, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.