Individual provider Active NPI

Katarina Marsh, PSYD

  • Clinical Psychologist
  • Madison, WI
National Provider Identifier
1376396903
Registry record updated Apr 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
5189-57 Issued in WI
Practice address
6510 Grand Teton PLZ Ste 102
Madison, WI 53719-1029
Phone
(608) 841-1606
NPI assigned
Apr 11, 2024
Last updated
Apr 11, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 5189-57 WI Primary

Addresses

Primary practice location

6510 Grand Teton PLZ Ste 102
Madison, WI 53719-1029

Mailing address

6510 Grand Teton PLZ Ste 102
Madison, WI 53719-1029

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20250529003720 MN Practitioner - Clinical Psychologist 1658880992 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optimal Brain MN PLLCGroup PAC ID 6709317787, 20 clinicians

Practice addresses (Care Compare)

992 Inwood Ave N
Oakdale, MN 55128-6625
Phone (651) 472-5915

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5189-57WIMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Optimal Brain MN, PLLC Clinical CurrentSince Mar 22, 2025 Accepting new patients
Madison Neuropsychological Services LLC Clinical CurrentSince Apr 14, 2024 Accepting new patients
Integrative Health, LLC PastSince Aug 4, 2021 Accepting new patients

Locations

992 Inwood Ave N
Saint Paul, MN 55128
Phone (612) 842-9814

6510 Grand Teton Plz
Ste 102
Madison, WI 53719
Phone (608) 841-1606

Organizations & group practices 3

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": "1712793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712793600000",
    "number": "1376396903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6510 GRAND TETON PLZ STE 102",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537191029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6510 GRAND TETON PLZ STE 102",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537191029",
            "telephone_number": "608-841-1606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSH",
        "first_name": "KATARINA",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-11",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WI",
            "license": "5189-57",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.