Active NPI
Karin Esther Flodstrom, PSY.D.
- Clinical Psychologist
- Thiensville, WI
National Provider Identifier
1679740559
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 2917-57
- Practice address
- 423 Green Bay Rd
Thiensville, WI 53092-1309 - Phone
- (262) 643-4612
- NPI assigned
- May 10, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 2917-57 | WI | Primary |
| Clinical Psychologist | 103TC0700X | 071.004132 | IL |
Addresses
Primary practice location
423 Green Bay Rd
Thiensville, WI 53092-1309
Mailing address
423 Green Bay Rd
Thiensville, WI 53092-1309
Phone (262) 643-4612
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 071.004132 | IL | MD | Clinical Psychologist |
| 2917-57 | WI | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210377600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1321315200000",
"number": "1679740559",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "423 GREEN BAY RD",
"city": "THIENSVILLE",
"state": "WI",
"postal_code": "530921309",
"telephone_number": "262-643-4612"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "423 GREEN BAY RD",
"city": "THIENSVILLE",
"state": "WI",
"postal_code": "530921309",
"telephone_number": "262-643-4612"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FLODSTROM",
"first_name": "KARIN",
"middle_name": "ESTHER",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-05-10",
"last_updated": "2011-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WI",
"license": "2917-57",
"primary": true
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IL",
"license": "071.004132",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Thiensville, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.