Active NPI
Kassandra Kellerman
- School Psychologist
- De Pere, WI
National Provider Identifier
1023957321
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- Practice address
- 1250 Swan Rd
De Pere, WI 54115-8266 - Phone
- (920) 337-1035
- NPI assigned
- Mar 25, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | Primary |
Addresses
Primary practice location
1250 Swan Rd
De Pere, WI 54115-8266
Mailing address
1700 Chicago St
De Pere, WI 54115-3418
Other practice location 1
650 S Michigan St
DE Pere, WI 54115-3267
Phone (920) 337-1036
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1774396800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1774396800000",
"number": "1023957321",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1700 CHICAGO ST",
"city": "DE PERE",
"state": "WI",
"postal_code": "541153418"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1250 SWAN RD",
"city": "DE PERE",
"state": "WI",
"postal_code": "541158266",
"telephone_number": "920-337-1035"
}
],
"practiceLocations": [
{
"address_1": "650 S Michigan St",
"address_purpose": "LOCATION",
"city": "DE Pere",
"state": "WI",
"postal_code": "541153267",
"country_code": "US",
"telephone_number": "920-337-1036",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KELLERMAN",
"first_name": "KASSANDRA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-03-25",
"last_updated": "2026-03-25",
"certification_date": "2026-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in De Pere, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.