IndividualActive
Eleanor Tidball, LPC-IT
NPI 1629607619 · Counseling Psychologist · New Berlin, WI
Provider details
- NPI number
- 1629607619
- Entity type
- Individual
- Primary specialty
- Counseling PsychologistBehavioral Health & Social Service Providers
- Credential
- LPC-IT
- Sex
- Female
- Sole proprietor
- Yes
- License
- 4590-226 (WI)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Practice location
13320 W Grange Ave
New Berlin, WI 53151-8131
Phone: (414) 467-3780
Approximate (ZIP-level) locationGet directions
Mailing address
13320 W Grange Ave
New Berlin, WI 53151-8131
Registry dates
- Enumerated
- 2020-04-02
- Last updated
- 2020-04-02
- Certified
- 2020-04-02
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.