Dawn Catherine Kroencke, PHD LP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071007446 Issued in IL

Practice address

2357 S Tamiami Trail Ste 3
PMB #174
Venice, FL 34293-5161

Phone

(941) 218-3821

NPI assigned

Dec 16, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Dawn Cahterine Davis Former name

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Clinical Psychologist

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Dr Hastings and Associates LLCGroup PAC ID 0143597229, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Full Health Journey, LLC

  • Clinical Psychologist
  • Venice, FL
  • NPI 1659128387

  IL

  Medicare reassignment NPD Authorized official
• Dr. Hastings & Associates LLC

  • Mental Health Counselor
  • Hinsdale, IL
  • NPI 1841623600
  Medicare reassignment Care Compare group NPD
• Samaritan Counseling Center

  • Marriage & Family Therapist
  • Winnetka, IL
  • NPI 1841397353
  NPD (past)

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

{
    "created_epoch": "1134691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727740800000",
    "number": "1497731962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2357 S TAMIAMI TRAIL STE 3",
            "address_2": "PMB #174",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342935161",
            "telephone_number": "941-218-3821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2357 S TAMIAMI TRAIL STE 3",
            "address_2": "PMB #174",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342935161",
            "telephone_number": "941-218-3821"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1208 Iroquois Ave Ste 404",
            "address_purpose": "LOCATION",
            "city": "Naperville",
            "state": "IL",
            "postal_code": "605631683",
            "country_code": "US",
            "telephone_number": "941-218-3821",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KROENCKE",
        "first_name": "DAWN",
        "middle_name": "CATHERINE",
        "name_prefix": "Dr.",
        "credential": "PHD LP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-16",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071007446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAWN",
            "last_name": "DAVIS",
            "middle_name": "CAHTERINE",
            "prefix": "MRS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Robert D. Kramer, M.D.
• Joel Sheldon Kreiss, DDS
• Jenna Rose Kretschmar, MS, CCC-SLP
• Noel Krijger, MA
• Kro Holdings, LLC
• Krzysztof Cierniak, LLC
• Yuriy Kuchmak, DMD
• Christina Kukula, D.O.
• Elwira Ewa Kulawik, D.C.
• Kuncheria Joseph MD PA

• Clinical Psychologist in Venice, FL
• Providers in Venice, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.