Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Samuel David Lustgarten, PHD

Individual provider Counseling Psychologist · NPI 1477197929

Dr. Samuel David Lustgarten, PHD is a Counseling Psychologist in Madison, Wisconsin. Practices as a sole proprietor and works from 2 locations. Licensed in Oregon and Wisconsin.

Licensed in
OR, WI
In the registry since
2019
Specialties on file
2
What do these letters mean?
PHD — Doctor of Philosophy
A research doctorate. In healthcare it usually sits alongside a clinical licence.

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Practice location Address checks out

702 N Blackhawk Ave Ste 205
Madison, WI 53705-3357
Phone: (720) 260-4362
Fax: (971) 999-0817
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 7409 Sw Capitol Hwy Ste 207, Portland, OR 97219-2432 — (720) 260-4362

Specialties & licences

Counseling Psychologist (primary) Taxonomy 103TC1900X · Licence 3717-57 (WI)
Counseling Psychologist Taxonomy 103TC1900X · Licence 3178 (OR)

Record details

NPI number1477197929
Entity typeIndividual (Type 1)
GenderMale
Credentials PHD
Sole proprietorYes
NPI enumeratedOctober 28, 2019
Last updated in NPPESDecember 29, 2022
Certification dateDecember 29, 2022
Mailing address702 N Blackhawk Ave Ste 205, Madison, WI 53705-3357

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