Individual provider Active NPI

Mariah Hewitt, PSYD

  • Clinical Psychologist
  • Racine, WI
National Provider Identifier
1558305409
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2534-057 Issued in WI
Practice address
840 Lake Ave
Ste 101
Racine, WI 53403-1566
Phone
(262) 634-8688
Fax
(262) 634-7547
NPI assigned
Jun 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 2534-057 WI Primary

Addresses

Primary practice location

840 Lake Ave
Ste 101
Racine, WI 53403-1566

Mailing address

409 Kennedy CT W
Colgate, WI 53017-9749
Phone (262) 993-4402

Other identifiers 1

IdentifierTypeStateIssuer
40960500MedicaidWI

Other names 1

  • Mariah Felde Other name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
2534-057WIMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Racine Psychological Services, Inc. Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1558305409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 KENNEDY CT W",
            "city": "COLGATE",
            "state": "WI",
            "postal_code": "530179749",
            "telephone_number": "262-993-4402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 LAKE AVE",
            "address_2": "STE 101",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534031566",
            "telephone_number": "262-634-8688",
            "fax_number": "262-634-7547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEWITT",
        "first_name": "MARIAH",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-15",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WI",
            "license": "2534-057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40960500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIAH",
            "last_name": "FELDE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Racine, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.