Healthcare Provider Details

I. General information

NPI: 1912411539
Provider Name (Legal Business Name): DANIELLE WINSTON PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2017
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7330 W LAYTON AVE
MILWAUKEE WI
53220-3849
US

IV. Provider business mailing address

7330 W LAYTON AVE
MILWAUKEE WI
53220-3849
US

V. Phone/Fax

Practice location:
  • Phone: 414-877-4570
  • Fax: 262-228-6257
Mailing address:
  • Phone: 414-877-4570
  • Fax: 266-244-1483

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number3769
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number071.009665
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number3769-057
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: