Klinton R. Krouse, HSPP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

20042736A Issued in IN

Practice address

2100 Goshen Rd
Fort Wayne, IN 46808-1493

Phone

(260) 471-3500

Fax

(260) 471-4263

NPI assigned

Nov 16, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1258329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392336000000",
    "number": "1558698357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 497",
            "address_2": "2621 E. JEFFERSON ST.",
            "city": "WARSAW",
            "state": "IN",
            "postal_code": "465810497",
            "telephone_number": "574-267-7169",
            "fax_number": "574-269-5573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 GOSHEN RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468081493",
            "telephone_number": "260-471-3500",
            "fax_number": "260-471-4263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KROUSE",
        "first_name": "KLINTON",
        "middle_name": "R.",
        "credential": "HSPP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-11-16",
        "last_updated": "2014-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39001609A",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20042736A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandon Christopher Krontz, RBT
• Kroser Limited Phartnership I
• Caitlin Krouse
• Chelsea M Krouse
• Kayleigh Christine Krouse
• Conchita Pagela Krueger, OTR
• Stefanie Jo Kruger, BS
• Jennifer Kruit
• Jennifer Krumwiede-McGowan
• Elaine Louise Kruse, PA-C

• Clinical Psychologist in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Clinical Psychologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2014; 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.