MEDICARE: HENRY STEINBERGER PHD LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TA0400X	Addiction (Substance Use Disorder) Psychologist	1285-057	WI
2	103T00000X	Psychologist	1285-057	WI

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	WI27460001	OTHER	WI	MEDICARE PTAN
4	WI2746	OTHER	WI	MEDICARE PTAN ORGANIZATION

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1285-057	OTHER	WI	PSYCHOLOGY LICENSE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1821358185
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HENRY STEINBERGER PHD LLC

Provider Business Mailing Address
First Line	:	313 PRICE PL
Second Line	:	SUITE 209
City	:	MADISON
State	:	WI
Zip	:	53705-3299
Country	:	US
Telephone Number	:	608-238-3894
Fax Number	:	608-238-3896

Provider Business Practice Location Address
First Line	:	313 PRICE PL
Second Line	:	SUITE 209
City	:	MADISON
State	:	WI
Zip	:	53705-3262
Country	:	US
Telephone Number	:	608-238-3894
Fax Number	:	608-238-3896

Authorized Official
Title or Position	:	LICENSED PSYCHOLOGIST
Name	:	DR. HENRY STEINBERGER
Credential	:	PH.D.
Telephone Number	:	608-238-3894

Provider Enumeration Date	:	05/21/2012
Last Update Date	:	12/07/2016

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Directions to “HENRY STEINBERGER PHD LLC ” Practice Location

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