Healthcare Provider Details

I. General information

NPI: 1568452423
Provider Name (Legal Business Name): ERIC HABREL PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/24/2005
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 ELM GROVE RD STE 325
ELM GROVE WI
53122-2561
US

IV. Provider business mailing address

500 ELM GROVE RD STE 325
ELM GROVE WI
53122-2561
US

V. Phone/Fax

Practice location:
  • Phone: 262-641-4347
  • Fax: 262-641-4350
Mailing address:
  • Phone: 262-641-4347
  • Fax: 262-641-4350

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number1316-057
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: