Individual provider Active NPI

Kerri Michele Lehman, PH.D.

  • Clinical Psychologist
  • Prairie Du Sac, WI
National Provider Identifier
1184665291
Registry record updated Mar 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2009-057 Issued in WI
Practice address
1190 Prairie St.
Prairie Du Sac, WI 53578
Phone
(608) 356-9055
Fax
(608) 356-5447
NPI assigned
Jun 9, 2006
Last updated
Mar 18, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 2009-057 WI
Clinical Psychologist 103TC0700X 2009-057 WI Primary

Addresses

Primary practice location

1190 Prairie St.
Prairie Du Sac, WI 53578

Mailing address

310 N. Midvale Blvd.
Suite 202
Madison, WI 53705
Phone (608) 238-9991

Other identifiers 1

IdentifierTypeStateIssuer
39120100MedicaidWI

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
I20040423000813 WI Practitioner - Clinical Psychologist 6406842459 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Psychology Clinic Inc.Group PAC ID 0143216747, 10 clinicians

Practice addresses (Care Compare)

702 N Blackhawk Ave
Suite 212
Madison, WI 53705-3357
Phone (608) 238-9991

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2009-057WIMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Psychology Clinic Inc. CurrentSince Mar 8, 2010 Accepting new patients
Christianson Pfau Chiropractic LLC PastSince Mar 8, 2010 Accepting new patients

Locations

310 N Midvale Blvd
Ste 202
Madison, WI 53705
Phone (608) 238-9991

702 N Blackhawk Ave
Ste 212
Madison, WI 53705
Phone (608) 238-9991

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": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268870400000",
    "number": "1184665291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 N. MIDVALE BLVD.",
            "address_2": "SUITE 202",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "53705",
            "telephone_number": "608-238-9991",
            "fax_number": "608-238-1929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1190 PRAIRIE ST.",
            "city": "PRAIRIE DU SAC",
            "state": "WI",
            "postal_code": "53578",
            "telephone_number": "608-356-9055",
            "fax_number": "608-356-5447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEHMAN",
        "first_name": "KERRI",
        "middle_name": "MICHELE",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-09",
        "last_updated": "2010-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "2009-057",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WI",
            "license": "2009-057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39120100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Prairie Du Sac, WI

Sources for this page

Verify at the official NPI Registry.