Individual provider Active NPI

Kristjana K Rahn, PSYD, LP

  • Clinical Psychologist
  • Oshkosh, WI
National Provider Identifier
1164154514
Registry record updated Aug 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3738-57 Issued in WI
Practice address
2935 Universal CT Ste 2
Oshkosh, WI 54904-6324
Phone
(844) 697-8766
Fax
(920) 416-8581
NPI assigned
Jun 25, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent Psychologist 103TC2200X
Clinical Psychologist 103TC0700X 3738-57 WI Primary

Addresses

Primary practice location

2935 Universal CT Ste 2
Oshkosh, WI 54904-6324

Mailing address

1900 Silver Lake Rd NW Ste 110
New Brighton, MN 55112-1789
Phone (844) 697-8766

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
I20240123001953 WI Practitioner - Clinical Psychologist 8527410810 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3738-57WIMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Nystrom & Associates Counseling Wi., S.C. CurrentSince Aug 18, 2025 Accepting new patients
Nystrom & Associates Counseling Wi., S.C. CurrentSince Aug 18, 2025 Accepting new patients

Locations

1900 Silver Lake Rd NW
Ste 110
Saint Paul, MN 55112
Phone (651) 379-1718

201 Main St
Ste 500
La Crosse, WI 54601
Phone (608) 668-4005

2935 Universal Ct
#2
Oshkosh, WI 54904
Phone (844) 697-8766

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1656115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755129600000",
    "number": "1164154514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 SILVER LAKE RD NW STE 110",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551121789",
            "telephone_number": "844-697-8766",
            "fax_number": "920-416-8581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2935 UNIVERSAL CT STE 2",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549046324",
            "telephone_number": "844-697-8766",
            "fax_number": "920-416-8581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAHN",
        "first_name": "KRISTJANA",
        "middle_name": "K",
        "credential": "PSYD, LP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-25",
        "last_updated": "2025-08-14",
        "certification_date": "2025-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WI",
            "license": "3738-57",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oshkosh, WI

Sources for this page

Verify at the official NPI Registry.