Moller, Michael J

Moller, Michael J is an sole proprietor health care provider with primary practice located at 900 6Th St N 102, Hudson WI 54016-7171. He recently has 5 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Clinical Child & Adolescent, Behavioral Health & Social Service Providers / Family, Behavioral Health & Social Service Providers / Forensic. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Moller, Michael J can be contacted via phone (715) 386-0856.

Contact Information

Primary practice address
900 6Th St N 102 Hudson WI 54016-7171
Phone: (715) 386-0856
Fax: (715) 386-0948
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 2320 Wisconsin
Behavioral Health & Social Service Providers / Clinical 103TC0700X 2320 Wisconsin
Behavioral Health & Social Service Providers / Clinical Child & Adolescent 103TC2200X 2320 Wisconsin
Behavioral Health & Social Service Providers / Family 103TF0000X 2320 Wisconsin
Behavioral Health & Social Service Providers / Forensic 103TF0200X 2320 Wisconsin

Profile Details

NPI number 1578647004
LBN Legal business name Moller, Michael J
Credentials PSYD
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 24th, 2006
Last updated Sep 28th, 2010 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578647004 NPPES
Wisconsin Other 2172193 COMPSYCH
Wisconsin Other 39739300 COMPSYCH
Wisconsin Other 431R2MO COMPSYCH
Wisconsin Other SSN001 COMPSYCH
Wisconsin Other 20558-03 COMPSYCH
Wisconsin Other 439K4MO COMPSYCH
Wisconsin Other 036J4MO COMPSYCH
Wisconsin MEDICAID 39739300 COMPSYCH
Wisconsin Other 61-74465 COMPSYCH
Wisconsin MEDICAID 880824400 COMPSYCH
Wisconsin Other HP20346 COMPSYCH
Wisconsin Other 61-74465 COMPSYCH
Wisconsin Other NA9031027526 COMPSYCH
Wisconsin Other 01413 COMPSYCH
Wisconsin Other 1202109 16675 COMPSYCH
Wisconsin Other 01413 COMPSYCH
Wisconsin Other 115830 COMPSYCH
Wisconsin Other SSN COMPSYCH

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