Organization
SEBASTIAN FAMILY PSYCHOLOGY PRACTICE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SEBASTIAN L SSEMPIJJA PHD (CLINIC DIRECTOR)
(414) 915-2967
Entity
Organization
Contact information
Practice address
6025 N GREEN BAY AVE, GLENDALE, WI 53209-3811
(414) 247-0801
(414) 247-0816
Mailing address
6025 N GREEN BAY AVE, GLENDALE, WI 53209-3811
(414) 247-0801
(414) 247-0816
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
1784-057
WI
103TB0200X
Cognitive & Behavioral Psychologist
1784-057
WI
103TC0700X
Clinical Psychologist
1784-057
WI
103TC2200X
Clinical Child & Adolescent Psychologist
1784-057
WI
104100000X
Social Worker
126576-121
WI
104100000X
Social Worker
160-123
WI
104100000X
Social Worker
302-123
WI
104100000X
Social Worker
3079-123
WI
171R00000X
Interpreter
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42236700
—
WI
Enumeration date
02/18/2007
Last updated
07/20/2023
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