Healthcare Provider Details

I. General information

NPI: 1447813100
Provider Name (Legal Business Name): STEINBRUECK PSYCHOLOGICAL SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2019
Last Update Date: 09/12/2021
Certification Date: 09/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5605 WASHINGTON AVE STE 8F
MT PLEASANT WI
53406-4056
US

IV. Provider business mailing address

5605 WASHINGTON AVE STE 8F
MT PLEASANT WI
53406-4056
US

V. Phone/Fax

Practice location:
  • Phone: 262-977-0088
  • Fax: 262-753-6821
Mailing address:
  • Phone: 262-977-0088
  • Fax: 262-753-6821

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. SUSAN MARIE STEINBRUECK
Title or Position: OWNER
Credential: PHD
Phone: 262-977-0088