Healthcare Provider Details

I. General information

NPI: 1407872567
Provider Name (Legal Business Name): LURA M. ASBY PSY.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 BAY VIEW RD STE C
MUKWONAGO WI
53149-1770
US

IV. Provider business mailing address

400 BAY VIEW RD STE C
MUKWONAGO WI
53149-1770
US

V. Phone/Fax

Practice location:
  • Phone: 262-999-3495
  • Fax: 262-821-6180
Mailing address:
  • Phone: 262-999-3495
  • Fax: 262-821-6180

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number2293-057
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: