Healthcare Provider Details

I. General information

NPI: 1407763667
Provider Name (Legal Business Name): MARGARET ELIZABETH SUTTLE PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4621 EASTPARK BLVD MADISON WI 53718 FLOOR 7
MADISON WI
53718
US

IV. Provider business mailing address

4621 EASTPARK BLVD MADISON WI 53718
MADISON WI
53718
US

V. Phone/Fax

Practice location:
  • Phone: 608-914-1400
  • Fax:
Mailing address:
  • Phone: 608-914-1400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number5567-57
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: