Active NPI
Kaitlyn Rikke Stollberg
- School Psychologist
- De Pere, WI
National Provider Identifier
1336903418
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 852897
- Practice address
- 1271 Crown CT
De Pere, WI 54115-3814 - Phone
- (920) 327-3416
- NPI assigned
- Feb 9, 2024
- Sex
- Female
- Sole proprietor
- Yes
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 | 852897 | WI | Primary |
Addresses
Primary practice location
1271 Crown CT
De Pere, WI 54115-3814
Mailing address
1271 Crown CT
De Pere, WI 54115-3814
Phone (920) 327-3416
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 852897 | WI | MD | School Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1707436800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707436800000",
"number": "1336903418",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1271 CROWN CT",
"city": "DE PERE",
"state": "WI",
"postal_code": "541153814",
"telephone_number": "920-327-3416"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1271 CROWN CT",
"city": "DE PERE",
"state": "WI",
"postal_code": "541153814",
"telephone_number": "920-327-3416"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STOLLBERG",
"first_name": "KAITLYN",
"middle_name": "RIKKE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-02-09",
"last_updated": "2024-02-09",
"certification_date": "2024-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "WI",
"license": "852897",
"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 Feb 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.