MEDICARE: THE CENTRE FOR HUMAN FLOURISHING, P.L.L.C.

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	103TC0700X	Clinical Psychologist	3157	NC

General Provider Information

NPI Number	:	1891810602
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE CENTRE FOR HUMAN FLOURISHING, P.L.L.C.

Provider Business Mailing Address
First Line	:	239 E. CHICAGO ST.
Second Line	:	#203
City	:	MILWAUKEE
State	:	WI
Zip	:	53202-3007
Country	:	US
Telephone Number	:	414-331-0952
Fax Number	:

Provider Business Practice Location Address
First Line	:	239 E. CHICAGO ST.
Second Line	:	#203
City	:	MILWAUKEE
State	:	WI
Zip	:	53202-3007
Country	:	US
Telephone Number	:	414-331-0952
Fax Number	:

Authorized Official
Title or Position	:	CLINICAL PSYCHOLOGIST, OWNER
Name	:	DR. DAWN R NELSON
Credential	:	PSY.D., M.DIV.
Telephone Number	:	414-331-0952

Provider Enumeration Date	:	03/20/2007
Last Update Date	:	08/12/2015

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