Basic Information
| Provider Information | |||||||||
| NPI: | 1760759971 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | UVS PSYCHOLOGICAL SERVICES LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6401 ODANA RD | ||||||||
| Address2: | SUITE 12 | ||||||||
| City: | MADISON | ||||||||
| State: | WI | ||||||||
| PostalCode: | 537191126 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6085161280 | ||||||||
| FaxNumber: | 6082746522 | ||||||||
| Practice Location | |||||||||
| Address1: | 6401 ODANA RD | ||||||||
| Address2: | SUITE 12 | ||||||||
| City: | MADISON | ||||||||
| State: | WI | ||||||||
| PostalCode: | 537191126 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6085161280 | ||||||||
| FaxNumber: | 6082746522 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/17/2011 | ||||||||
| LastUpdateDate: | 05/02/2012 | ||||||||
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| AuthorizedOfficialLastName: | SKIBICKY | ||||||||
| AuthorizedOfficialFirstName: | ULIANA | ||||||||
| AuthorizedOfficialMiddleName: | V | ||||||||
| AuthorizedOfficialTitleorPosition: | CLINICIAN OWNER | ||||||||
| AuthorizedOfficialTelephone: | 6085161280 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | PHD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC1900X | 301357 | WI | Y | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Psychologist | Counseling |
No ID Information.