Keystone Psychology LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

KEYSTONE PSYCHOLOGY LLC

Practice address

2131 S Webster Ave
Suite 105
Green Bay, WI 54301-2288

Phone

(920) 366-7792

Fax

(920) 227-4117

NPI assigned

Dec 2, 2007

Last updated

Nov 4, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Kevin Wayne Miller, PHDNPI 1407920283

Title

Psychologist

Phone

(920) 366-7792

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Kevin Wayne Miller, PHD

  • Clinical Psychologist
  • Green Bay, WI
  • NPI 1407920283
  Authorized official Same address or phone

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

{
    "created_epoch": "1196553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288828800000",
    "number": "1649452608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2131 S WEBSTER AVE",
            "address_2": "SUITE 105",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543012288",
            "telephone_number": "920-366-7792",
            "fax_number": "920-227-4117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2131 S WEBSTER AVE",
            "address_2": "SUITE 105",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543012288",
            "telephone_number": "920-366-7792",
            "fax_number": "920-227-4117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEYSTONE PSYCHOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-02",
        "last_updated": "2010-11-04",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "920-366-7792",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aliece Ann Kerscher
• Kyle Kershek, LPC
• Cynthia Vida Ketter, PHYSICAL THERAPIST
• Rebecca L Ketterhagen, PA
• Masin Kettner
• Sany T Khabbaz, MD
• Hadi Mohammad Khan, M.D.
• Muhammad Irshad Khan, MD
• Mujtaba Khan
• Shiza N Khan

• Community/Behavioral Health Agency in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Community/Behavioral Health Agency in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2010; 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.