Organization
CLEAR DIRECTION PSYCHOLOGICAL SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FRANK URTZ PHD (PRESIDENT)
(414) 332-3390
Entity
Organization
Contact information
Practice address
6110 N PORT WASHINGTON RD, GLENDALE, WI 53217-4308
(414) 332-3390
(414) 332-3392
Mailing address
6110 N PORT WASHINGTON RD, GLENDALE, WI 53217-4308
(414) 332-3390
(414) 332-3392
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
157211
VALUEOPTIONS PROVIDER
WI
01
—
166708
MANAGED HEALTH NETWORK
WI
05
—
39020900
—
WI
01
—
4017291
AETNA PROVIDER NUMBER
WI
01
—
V543N
BLUE CROSS BLUE SHIELD
WI
Enumeration date
04/17/2007
Last updated
04/18/2013
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