IndividualActive
Samuel Lustgarten, PHD
NPI 1477197929 · Counseling Psychologist · Madison, WI
Provider details
- NPI number
- 1477197929
- Entity type
- Individual
- Primary specialty
- Counseling PsychologistBehavioral Health & Social Service Providers
- Credential
- PHD
- Sex
- Male
- Sole proprietor
- Yes
- License
- 3178 (OR)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Behavioral Health & Social Service Providers
Practice location
702 N Blackhawk Ave Ste 205
Madison, WI 53705-3357
Phone: (720) 260-4362
Fax: (971) 999-0817
Approximate (ZIP-level) locationGet directions
Mailing address
702 N Blackhawk Ave Ste 205
Madison, WI 53705-3357
Additional practice locations (1)
- 7409 Sw Capitol Hwy Ste 207Portland, OR 97219-2432Phone: (720) 260-4362Fax: (971) 999-0817
Registry dates
- Enumerated
- 2019-10-28
- Last updated
- 2022-12-29
- Certified
- 2022-12-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.