Active NPI
Brooke E. Lundbohm, PSY.D.
- Psychologist
- Milwaukee, WI
National Provider Identifier
1992042337
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 2823-057
- Practice address
- 740 N Plankinton Ave Ste 334
Milwaukee, WI 53203-2403 - Phone
- (414) 271-5511
- NPI assigned
- Jan 4, 2013
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 2823-057 | WI | Primary |
Addresses
Primary practice location
740 N Plankinton Ave Ste 334
Milwaukee, WI 53203-2403
Mailing address
740 N Plankinton Ave Ste 334
Milwaukee, WI 53203-2403
Phone (414) 271-5511
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 |
|---|---|---|---|
| 2823-057 | WI | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1357257600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1357257600000",
"number": "1992042337",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "740 N PLANKINTON AVE STE 334",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532032403",
"telephone_number": "414-271-5511"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "740 N PLANKINTON AVE STE 334",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532032403",
"telephone_number": "414-271-5511"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUNDBOHM",
"first_name": "BROOKE",
"middle_name": "E.",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-01-04",
"last_updated": "2013-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "WI",
"license": "2823-057",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Milwaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.