CDL Psychological Services, Inc.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

3349-57 Issued in WI

Legal business name

CDL PSYCHOLOGICAL SERVICES, INC.

Practice address

410 Johnson Pkwy
Hammond, WI 54015-9678

Phone

(715) 497-7230

Fax

(715) 600-9041

NPI assigned

Feb 19, 2016

Last updated

Sep 5, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Greg William Anderson, PSY.D.NPI 1790157469

Title

Clinical Psychologist

Phone

(715) 497-7230

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Greg Anderson, L.P.

  • Psychologist
  • Hammond, WI
  • NPI 1790157469
  NPD Authorized official

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

{
    "created_epoch": "1455840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473033600000",
    "number": "1982063897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 JOHNSON PKWY",
            "city": "HAMMOND",
            "state": "WI",
            "postal_code": "540159678",
            "telephone_number": "715-497-7230",
            "fax_number": "715-600-9023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 JOHNSON PKWY",
            "city": "HAMMOND",
            "state": "WI",
            "postal_code": "540159678",
            "telephone_number": "715-497-7230",
            "fax_number": "715-600-9041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CDL PSYCHOLOGICAL SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-19",
        "last_updated": "2016-09-05",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "GREG",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "715-497-7230",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WI",
            "license": "3349-57",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Greg Anderson, L.P.
• Rachel Benck, LDH
• Elizabeth Ann Brown, COTA
• Krista Demuth
• Lori Jean Edwards, RPT
• Extendicare Homes, Inc. (American Heritage Care Center)
• Dennis Ferguson
• FMG Davis Street SNF Wisconsin LLC (American Heritage)

• Clinical Psychologist in Hammond, WI
• Providers in Hammond, WI by specialty
• Clinical Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2016; 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.