=====================================================
General NPI Number Information
=====================================================
NPI Number | 1164307898
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DEPTH & CLARITY PSYCHOLOGY
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/11/2025
-----------------------------------------------------
Last Update Date | 10/03/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 890 ELM GROVE RD STE 100-2
-----------------------------------------------------
City | ELM GROVE
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 53122-2552
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 262-269-4665
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 850 ELM GROVE RD STE 17
-----------------------------------------------------
City | ELM GROVE
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 53122-2527
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 414-909-0114
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/CLINICAL PSYCHOLOGIST
-----------------------------------------------------
Name | ANNA WEBER
-----------------------------------------------------
Credential | PSYD, LP
-----------------------------------------------------
Telephone | 414-909-0114
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103TC0700X
-----------------------------------------------------
Taxonomy Name | Clinical Psychologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------