MEDICARE: DR. JEFFREY D. LIGMAN PSY.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	WI1281057	WI
2	103T00000X	Psychologist	WI1281057	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1281-057	OTHER	WI	PSYCHOLOGIST LICENSE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1538148812
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFREY D. LIGMAN PSY.D.

Provider Business Mailing Address
First Line	:	10045 W LISBON AVE STE 250
Second Line	:
City	:	WAUWATOSA
State	:	WI
Zip	:	53222-2446
Country	:	US
Telephone Number	:	414-358-7150
Fax Number	:	414-393-1640

Provider Business Practice Location Address
First Line	:	10045 W LISBON AVE
Second Line	:	SUITE 108
City	:	WAUWATOSA
State	:	WI
Zip	:	53222-2446
Country	:	US
Telephone Number	:	414-358-7150
Fax Number	:	414-393-1640

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/13/2006
Last Update Date	:	02/01/2024

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Directions to “ DR. JEFFREY D. LIGMAN PSY.D.” Practice Location

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