Active NPI
Tom Crockett
- School Psychologist
- Iola, WI
National Provider Identifier
1710818265
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 661651
- Practice address
- 450 Division St
Iola, WI 54945-9629 - Phone
- (715) 445-2411
- NPI assigned
- May 26, 2026
- Last updated
- May 26, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 661651 | WI | Primary |
Addresses
Primary practice location
450 Division St
Iola, WI 54945-9629
Mailing address
151409 Lily LN
Rib Mountain, WI 54401-5427
Phone (888) 801-2666
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 |
|---|---|---|---|
| 661651 | WI | MD | School Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Iola Scandinavia School District | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Local Education Agency (LEA)
- Iola, WI
- NPI 1932393493
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1779753600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1779753600000",
"number": "1710818265",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "151409 LILY LN",
"city": "RIB MOUNTAIN",
"state": "WI",
"postal_code": "544015427",
"telephone_number": "888-801-2666"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "450 DIVISION ST",
"city": "IOLA",
"state": "WI",
"postal_code": "549459629",
"telephone_number": "715-445-2411"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CROCKETT",
"first_name": "TOM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-05-26",
"last_updated": "2026-05-26",
"certification_date": "2026-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "WI",
"license": "661651",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Iola, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 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.