Individual provider Active NPI

Catherine Anne McConnell, PHD

  • Psychologist
  • Kenosha, WI
National Provider Identifier
1013061761
Registry record updated Jun 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
2336 Issued in WI
Practice address
625 57TH St Ste 502
Kenosha, WI 53140-4146
Phone
(262) 419-2277
Fax
(920) 215-6164
NPI assigned
Jan 22, 2007
Last updated
Jun 24, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 2336 WI Primary
Clinical Psychologist 103TC0700X 071006290 IL

Addresses

Primary practice location

625 57TH St Ste 502
Kenosha, WI 53140-4146

Mailing address

325 N Commercial St
Neenah, WI 54956-2665
Phone (262) 419-2277

Other identifiers 2

IdentifierTypeStateIssuer
342856OtherILMHN
7192312OtherILAETNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240703003476 WI Practitioner - Clinical Psychologist 5991767543 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
LK Anderson Consulting LLCGroup PAC ID 8325489438, 11 clinicians

Practice addresses (Care Compare)

625 57TH St
Suite 502
Kenosha, WI 53140-4146
Phone (262) 419-2277

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
LK Anderson Consulting LLC CurrentSince May 14, 2024 Accepting new patients
Radiology Associates of the Fox Valley, SC PastSince Jun 29, 2025 Accepting new patients

Locations

625 57th St
Ste 502
Kenosha, WI 53140
Phone (262) 419-2277

145 W Wisconsin Ave
Neenah, WI 54956
Phone (920) 212-6050

325 N Commercial St
Neenah, WI 54956
Phone (920) 722-1583

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750723200000",
    "number": "1013061761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 N COMMERCIAL ST",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549562665",
            "telephone_number": "262-419-2277",
            "fax_number": "920-215-6164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 57TH ST STE 502",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531404146",
            "telephone_number": "262-419-2277",
            "fax_number": "920-215-6164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCONNELL",
        "first_name": "CATHERINE",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-22",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "2336",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071006290",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN",
            "identifier": "342856",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7192312",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenosha, WI

Sources for this page

Verify at the official NPI Registry.