Kelli Lynn Douville, LP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

3020-57 Issued in WI

Practice address

1001 Fourier Dr Ste 200
Madison, WI 53717-1958

Phone

(608) 740-2001

NPI assigned

May 14, 2026

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Specialty

Clinical Psychologist

Education

Other, 2008

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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 and National Provider Directory roles.

• Nystrom & Associates Counseling Wi., S.C.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fargo, ND
  • NPI 1104549047
  NPD (past)

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

{
    "created_epoch": "1778716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780963200000",
    "number": "1831028232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 SILVER LAKE RD NW STE 110",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551121789",
            "telephone_number": "651-628-9566",
            "fax_number": "651-628-0411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 FOURIER DR STE 200",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537171958",
            "telephone_number": "608-740-2001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUVILLE",
        "first_name": "KELLI",
        "middle_name": "LYNN",
        "credential": "LP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-05-14",
        "last_updated": "2026-06-09",
        "certification_date": "2026-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WI",
            "license": "3020-57",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carolyn Kay Douglas, PA-C
• Heather H Douglas, MS, CTRS,LPC
• Katherine Douglas, PT, DPT
• Tyler Douglas
• Leah K Doupe, APNP
• David M. Dow, D.C.
• Jordan Frederick Dow
• Ivalee Dowd, PA
• Amanda Nichole Dowden, PTA CLT
• Hunter Sean Dowds, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.