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Contact Information

MARC W ZYLSTRA, PhD
2525 N MAYFAIR RD
SUITE 200
WAUWATOSA, WI53226-1403
 Phone: 414-476-8183
 Fax: 414-476-8465
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Group Psychotherapy

103TP2701X 62 Psychologist, Clinical
 

Clinical

103TC0700X 62 Psychologist, Clinical
 

Health Service

103TH0100X 62 Psychologist, Clinical
 

Psychologist

103T00000X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for MARC W ZYLSTRA · (Male)

NPI # 1295847002
Status Active
Credentials PhD
Entity Individual
Enumeration date 08/31/2006
Last updated 09/11/2025 - About 9 months ago
Sole proprietor 1 No
Identifiers
  • WI License # 1817-057
  • WI License # 43715
  • WI Medicaid 21280000
  • WI Medicaid 39640900
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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