Active NPI
Thomas Speech, PHD
- Clinical Psychologist
- Neenah, WI
National Provider Identifier
1710501168
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1587-57
- Practice address
- 601 Kessler Dr.
Neenah, WI 54956-4113 - Phone
- (920) 419-0680
- Fax
- (920) 214-1128
- NPI assigned
- Jun 2, 2020
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Forensic Psychologist | 103TF0200X | 1587-57 | WI | |
| Clinical Psychologist | 103TC0700X | 1587-57 | WI | Primary |
Addresses
Primary practice location
601 Kessler Dr.
Neenah, WI 54956-4113
Mailing address
601 Kessler Dr.
Neenah, WI 54956-4113
Phone (920) 419-0680
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | https://spruce.care/9203158238 | Health Information Exchange (HIE) |
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1587-57 | WI | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1591056000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1591056000000",
"number": "1710501168",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "601 KESSLER DR.",
"city": "NEENAH",
"state": "WI",
"postal_code": "549564113",
"telephone_number": "920-419-0680"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 KESSLER DR.",
"city": "NEENAH",
"state": "WI",
"postal_code": "549564113",
"telephone_number": "920-419-0680",
"fax_number": "920-214-1128"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPEECH",
"first_name": "THOMAS",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-06-02",
"last_updated": "2020-06-02",
"certification_date": "2020-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "103TF0200X",
"taxonomy_group": "",
"desc": "Psychologist, Forensic",
"state": "WI",
"license": "1587-57",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WI",
"license": "1587-57",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "https://spruce.care/9203158238",
"affiliation": "N",
"endpointDescription": "Allows link to download Sprucehealth application",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Text messages",
"address_1": "601 Kessler Dr.",
"city": "Neenah",
"state": "WI",
"country_code": "US",
"postal_code": "549564113",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Neenah, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.