Individual provider Active NPI

Cecily Anne Herby, PSYD

  • Clinical Neuropsychologist
  • Menasha, WI
National Provider Identifier
1821874645
Registry record updated Oct 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
5453 Issued in WI
Practice address
1095 Midway Rd
Menasha, WI 54952-1115
Phone
(920) 720-2300
Fax
(920) 720-3719
NPI assigned
Sep 6, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 5453 WI Primary
Clinical Neuropsychologist 103G00000X

Addresses

Primary practice location

1095 Midway Rd
Menasha, WI 54952-1115

Mailing address

3 Neenah Ctr
Neenah, WI 54956-3070
Phone (920) 830-5900

Other practice location 1

2301 25th St S
Fargo, ND 58103-6104
Phone (701) 417-6600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251017001234 WI Practitioner - Neuropsychiatry 1759878176 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neuropsychiatry
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thedacare, IncorporatedGroup PAC ID 1759294887, 654 clinicians

Practice addresses (Care Compare)

1095 Midway Rd
Menasha, WI 54952-1115
Phone (920) 720-2300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Thedacare, Incorporated CurrentSince Oct 7, 2025 Accepting new patients
Thedacare, Incorporated Clinical Neuropsychologist CurrentSince Oct 7, 2025 Accepting new patients

Locations

1818 N Meade St
Appleton, WI 54911
Phone (920) 731-4101

1095 Midway Rd
Menasha, WI 54952
Phone (920) 720-3700

3 Neenah Ctr
Neenah, WI 54956
Phone (920) 454-4229

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1693958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759881600000",
    "number": "1821874645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 NEENAH CTR",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549563070",
            "telephone_number": "920-830-5900",
            "fax_number": "920-830-5910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1095 MIDWAY RD",
            "city": "MENASHA",
            "state": "WI",
            "postal_code": "549521115",
            "telephone_number": "920-720-2300",
            "fax_number": "920-720-3719"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2301 25th St S",
            "address_purpose": "LOCATION",
            "city": "Fargo",
            "state": "ND",
            "postal_code": "581036104",
            "country_code": "US",
            "telephone_number": "701-417-6600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERBY",
        "first_name": "CECILY",
        "middle_name": "ANNE",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-06",
        "last_updated": "2025-10-08",
        "certification_date": "2025-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "WI",
            "license": "5453",
            "primary": true
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Menasha, WI

Sources for this page

Verify at the official NPI Registry.