Dale Anthony Bespalec, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

676-057 Issued in WI

Practice address

9120 W Hampton Ave
Suite 212
Milwaukee, WI 53225-4960

Phone

(414) 464-9777

Fax

(414) 358-5590

NPI assigned

Dec 5, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982762670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1911 MARYGLADE DR",
            "city": "GRAFTON",
            "state": "WI",
            "postal_code": "530249656",
            "telephone_number": "414-464-9777",
            "fax_number": "414-338-5590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9120 W HAMPTON AVE",
            "address_2": "SUITE 212",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532254960",
            "telephone_number": "414-464-9777",
            "fax_number": "414-358-5590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BESPALEC",
        "first_name": "DALE",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "676-057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Psychologist in Wisconsin

• 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.

Verify at the official NPI Registry.