Active NPI
Timothy Laughlin
- Clinical Psychologist
- Brookfield, WI
National Provider Identifier
1972669398
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1179-057
- Practice address
- 13035 W Bluemound Rd
Suite 100
Brookfield, WI 53005-8001 - Phone
- (262) 784-9777
- NPI assigned
- Dec 29, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 1179-057 | WI | Primary |
Addresses
Primary practice location
13035 W Bluemound Rd
Suite 100
Brookfield, WI 53005-8001
Mailing address
13035 W Bluemound Rd
Suite 100
Brookfield, WI 53005-8001
Phone (262) 784-9777
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1179-057 | WI | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167350400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1972669398",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13035 W BLUEMOUND RD",
"address_2": "SUITE 100",
"city": "BROOKFIELD",
"state": "WI",
"postal_code": "530058001",
"telephone_number": "262-784-9777"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13035 W BLUEMOUND RD",
"address_2": "SUITE 100",
"city": "BROOKFIELD",
"state": "WI",
"postal_code": "530058001",
"telephone_number": "262-784-9777"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAUGHLIN",
"first_name": "TIMOTHY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WI",
"license": "1179-057",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brookfield, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.