Craig Alan Modell in West Allis - Psychologist
Craig Alan Modell - NPI 1366552887
Craig Alan Modell is a Psychologist in West Allis, Wisconsin. Craig Alan Modell practices all healthcare services and medical treatments related to Psychologist. The NPI Number for Craig Alan Modell is 1366552887. The last update date is 2007-07-08.
Craig Alan Modell's current location address is 10229 W Greenfield Ave, West Allis, Wisconsin. You can contact this provider via phone number 4144536330 and fax number 4144536523. The mailing address for Craig Alan Modell is 10229 W Greenfield Ave, West Allis, Wisconsin. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Craig Alan Modell |
|---|---|
| Address | 10229 W Greenfield Ave, West Allis, Wisconsin |
| Phone Number | 4144536330 |
| Fax Number | 4144536523 |
| Sole Proprietor | N |
| Credentials | PHD PSYCHO |
NPI Number Detail
| NPI Number | 1366552887 |
|---|---|
| Provider Enumeration Date | 2006-08-30 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 10229 W Greenfield Ave |
|---|---|
| City | West Allis |
| State | Wisconsin (WI) |
| Post Code | 53214 |
| Phone Number | 4144536330 |
| Fax Number | 4144536523 |
Provider's Primary Taxonomy Detail
| Speciality | Psychologist |
|---|---|
| Taxonomy | 103T00000X |
| Licence No | 696057 |
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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 |
|---|---|---|---|
| 39097200 | WI | -- |
Post Comment/ Review Below
What is the Craig Alan Modell's 1366552887?
The Craig Alan Modell's NPI (National Provider Identifier) Number is 1366552887. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete physical address where Craig Alan Modell is located?
The Craig Alan Modell is situated at the following address: 10229 W Greenfield Ave, West Allis, WI, 53214.
What is the Craig Alan Modell's area of specialization and corresponding taxonomy classification?
The Craig Alan Modell's specialty field is Psychologist, and it falls under the taxonomy code 103T00000X, which categorizes healthcare providers based on their specialties.
On what date did Craig Alan Modell receive its 1366552887 assignment from the Centers for Medicare & Medicaid Services?
The Craig Alan Modell was assigned its 1366552887 on 2006-08-30, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
As of what date were the details related to Craig Alan Modell most recently updated or revised?
The information pertaining to Craig Alan Modell, including its address, specialty, and other relevant details, was last updated or revised on 2007-07-08.