Dynamic Potential

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

Legal business name

DYNAMIC POTENTIAL

Practice address

316 5TH St Ste 2
Racine, WI 53403-4606

Phone

(262) 308-8085

NPI assigned

Dec 19, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Stephanie R Raszkiewicz, PHDNPI 1952577629

Title

Licensed Psychologist

Phone

(262) 308-8085

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Stephanie R Raszkiewicz, PHD, CSAC

  • Psychologist
  • Racine, WI
  • NPI 1952577629
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1576713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582502400000",
    "number": "1023656162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1943",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531411943",
            "telephone_number": "262-308-8085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 5TH ST STE 2",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534034606",
            "telephone_number": "262-308-8085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYNAMIC POTENTIAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-19",
        "last_updated": "2020-02-24",
        "certification_date": "2020-02-24",
        "status": "A",
        "authorized_official_last_name": "RASZKIEWICZ",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "LICENSED PSYCHOLOGIST",
        "authorized_official_telephone_number": "262-308-8085",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40968000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paul C. Durbin, M.D.
• Kizzie Marie Durgom, RN
• Mary C. Dutkiewicz, N.P.
• Richard Dvorsky, RPH
• Juliann Kay Dykstra, B.C.-H.I.S.
• E Bruns Foot and Ankle SC
• Valerie J Earl, LCSW
• Barbara L Earnest, M.D.
• Ears and Empathy
• Daquasia East

• Counseling Psychologist in Racine, WI
• Providers in Racine, WI by specialty
• Counseling Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.