Ethan R Everett is a Psychologist in La Crosse, Wisconsin. Ethan R Everett practices all healthcare services and medical treatments related to Psychologist. The NPI Number for Ethan R Everett is 1235123134. The last update date is 2016-04-19.
Ethan R Everett's current location address is 1836 South Ave, La Crosse, Wisconsin. You can contact this provider via phone number 6087827300. The mailing address for Ethan R Everett is 1836 South Ave, La Crosse, Wisconsin. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Ethan R Everett |
|---|---|
| Address | 1836 South Ave, La Crosse, Wisconsin |
| Phone Number | 6087827300 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | PSYD |
NPI Number Detail
| NPI Number | 1235123134 |
|---|---|
| Provider Enumeration Date | 2005-09-07 |
| Last Updated Date | 2016-04-19 |
Provider Mailing Address Detail
| Address | 1836 South Ave |
|---|---|
| City | La Crosse |
| State | Wisconsin (WI) |
| Post Code | 546015429 |
| Phone Number | 6087827300 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Psychologist |
|---|---|
| Taxonomy | 103T00000X |
| Licence No | 2075 |
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Definition: A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and proce |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 39119600 | WI | -- |
Post Comment/ Review Below
What is the Ethan R Everett's 1235123134?
The Ethan R Everett's NPI (National Provider Identifier) Number is 1235123134. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you share the physical location details of Ethan R Everett?
The Ethan R Everett is situated at 1836 South Ave, in the city of La Crosse, state of WI, with the zip code 546015429.
What is Ethan R Everett's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Ethan R Everett's specialized field of practice is Psychologist, and the corresponding taxonomy code that categorizes this area of specialization is 103T00000X.
On what date did the Ethan R Everett receive its 1235123134 assignment from the Centers for Medicare & Medicaid Services?
The Ethan R Everett was assigned its 1235123134 by the Centers for Medicare & Medicaid Services on 2005-09-07.
When was the information regarding Ethan R Everett, such as address, specialty, and other details, most recently verified or confirmed to be accurate?
The information pertaining to Ethan R Everett, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2016-04-19.