Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 1285-057 | WI |
Y | 103T00000X | Psychologist | 1285-057 | WI |
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 1285-057 | WI |
N | 103TC1900X | Counseling Psychologist | 1285-057 | WI |
NPI | 1487688859 |
---|---|
Provider Name | Dr. Henry Steinberger |
First Address | Madison, WI 53705-3262 |
Second Address | Madison, WI 53705-3262 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2006 |
Last Update Date | 18/05/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1285-057 | PSYCHOLOGY LICENSE (01) | WI |
1487688859 | (05) | WI |
WI1776-001 | MEDICARE PTAN (01) | WI |