Active NPI
Keley Autin, PHD
- Psychologist
- Fox Point, WI
National Provider Identifier
1225900418
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 413557
- Practice address
- 221 W Suburban Dr
Fox Point, WI 53217-2300 - Phone
- (772) 240-9031
- NPI assigned
- Sep 18, 2025
- Last updated
- Sep 18, 2025
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 413557 | WI | Primary |
Addresses
Primary practice location
221 W Suburban Dr
Fox Point, WI 53217-2300
Mailing address
2400 E Hartford Ave # 791
Milwaukee, WI 53211-3159
Phone (772) 240-9031
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 413557 | WI | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1758153600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1758153600000",
"number": "1225900418",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2400 E HARTFORD AVE # 791",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532113159",
"telephone_number": "772-240-9031"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "221 W SUBURBAN DR",
"city": "FOX POINT",
"state": "WI",
"postal_code": "532172300",
"telephone_number": "772-240-9031"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AUTIN",
"first_name": "KELEY",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-09-18",
"last_updated": "2025-09-18",
"certification_date": "2025-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "WI",
"license": "413557",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fox Point, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.