Organization · Type 2 NPI

South Street Clinic LLC

Clinical Psychologist · Oconomowoc, WI

NPI number 1235128356 Active

Practice location

416 W South St
Oconomowoc, WI 53066-2755

Fax (262) 567-3097

Specialties and licenses

TaxonomyCodeLicense
Clinical Psychologist Primary 103TC0700X1841 (WI)

Clinical Psychologist: A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of discip…

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About NPI 1235128356

South Street Clinic LLC's National Provider Identifier is 1235128356, issued on Oct 20, 2005. The primary taxonomy on file is Clinical Psychologist (103TC0700X), and the practice location is in Oconomowoc, WI. The record was last updated on Aug 22, 2020.