Benjamin I De Boer, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

3452-57 Issued in WI

Practice address

2916 Marketplace Dr Ste 206&207
Fitchburg, WI 53719-5325

Phone

(401) 864-6246

NPI assigned

Jun 26, 2023

Last updated

Jan 18, 2026By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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)

Not enrolled

State licenses

Practice roles

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.

• Benjamin de Boer PSYD LLC

  • Clinical Psychologist
  • Fitchburg, WI
  • NPI 1992540876
  NPD Authorized official

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

{
    "created_epoch": "1687737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768694400000",
    "number": "1659057446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2916 MARKETPLACE DR STE 206&207",
            "city": "FITCHBURG",
            "state": "WI",
            "postal_code": "537195325",
            "telephone_number": "401-864-6246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2916 MARKETPLACE DR STE 206&207",
            "city": "FITCHBURG",
            "state": "WI",
            "postal_code": "537195325",
            "telephone_number": "401-864-6246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE BOER",
        "first_name": "BENJAMIN",
        "middle_name": "I",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-06-26",
        "last_updated": "2026-01-18",
        "certification_date": "2026-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WI",
            "license": "3452-57",
            "primary": true
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Teresa P Darcy, MD
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• Carla Mae Davey, PHD
• Marie J De Stadler, MS CCC-SLP
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• Jeffrey Deal
• Lindsey Deans, CCC-SLP
• Carol Elizabeth Delfosse, LMFT

• Clinical Psychologist in Fitchburg, WI
• Providers in Fitchburg, WI by specialty
• Clinical Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 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.