NPIMap

Organization Active NPI

Fleming Psychological Services, SC

  • Clinical Psychologist
  • Kenosha, WI
National Provider Identifier
1366526097
Registry record updated Feb 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
FLEMING PSYCHOLOGICAL SERVICES, SC
Practice address
6121 Green Bay Rd
Ste. 230
Kenosha, WI 53142-2926
Phone
(262) 654-8366
Fax
(262) 842-0444
NPI assigned
Oct 25, 2006
Last updated
Feb 10, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2017

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

Authorized official

Name
Ann M. Fleming, MSW, LCSWNPI 1184709230
Title
Owner/Psychotherapist
Phone
(262) 654-8366

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X Primary
Clinical Child & Adolescent PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC2200X
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X

Addresses

Primary practice location

6121 Green Bay Rd
Ste. 230
Kenosha, WI 53142-2926

Mailing address

6121 Green Bay Rd
Ste. 230
Kenosha, WI 53142-2926
Phone (262) 654-8366

Other names 1

  • Johansen & Fleming Psychological Services, SC Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050705000738 WI Part B Supplier - Clinic/Group Practice 7810933462 Receives reassigned benefits from 6 practitioners
Practice locations: Kenosha, WI

National Provider Directory

National Provider Directory

Locations

6121 Green Bay Rd
Ste 230
Kenosha, WI 53142
Phone (262) 654-8366

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486684800000",
    "number": "1366526097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6121 GREEN BAY RD",
            "address_2": "STE. 230",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531422926",
            "telephone_number": "262-654-8366",
            "fax_number": "262-842-0444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6121 GREEN BAY RD",
            "address_2": "STE. 230",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531422926",
            "telephone_number": "262-654-8366",
            "fax_number": "262-842-0444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLEMING PSYCHOLOGICAL SERVICES, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2017-02-10",
        "status": "A",
        "authorized_official_last_name": "FLEMING",
        "authorized_official_first_name": "ANN",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "OWNER/PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "262-654-8366",
        "authorized_official_credential": "MSW, LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Johansen & Fleming Psychological Services, SC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Kenosha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.