Individual provider Active NPI

Tonya Klem, ED.S

  • School Psychologist
  • Menomonie, WI
National Provider Identifier
1902264328
Registry record updated Jun 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
School PsychologistTaxonomy code 103TS0200X
License
900-58 Issued in WI
Practice address
800 Wilson Ave
Menomonie, WI 54751-2734
Phone
(715) 256-7166
NPI assigned
Jan 29, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
School Psychologist 103TS0200X 3001018297 WI
School Psychologist 103TS0200X 900-58 WI Primary

Addresses

Primary practice location

800 Wilson Ave
Menomonie, WI 54751-2734

Mailing address

918 10TH Ave E
Menomonie, WI 54751-2724
Phone (715) 529-5374

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL EHR Direct Thrive Psychological and Consulting Services LLC

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

LicenseStateTypeSpecialty
3001018297WIMDSchool Psychologist
900-58WIMDSchool Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Psychological and Consulting Services LLC School CurrentSince Jun 12, 2022 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1454025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655164800000",
    "number": "1902264328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "918 10TH AVE E",
            "city": "MENOMONIE",
            "state": "WI",
            "postal_code": "547512724",
            "telephone_number": "715-529-5374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 WILSON AVE",
            "city": "MENOMONIE",
            "state": "WI",
            "postal_code": "547512734",
            "telephone_number": "715-256-7166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEM",
        "first_name": "TONYA",
        "credential": "ED.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-29",
        "last_updated": "2022-06-14",
        "certification_date": "2022-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "WI",
            "license": "3001018297",
            "primary": false
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "WI",
            "license": "900-58",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "EHR",
            "affiliation": "Y",
            "endpointDescription": "Simple Practice",
            "affiliationName": "Thrive Psychological and Consulting Services LLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "800 Wilson Ave",
            "city": "Menomonie",
            "state": "WI",
            "country_code": "US",
            "postal_code": "547512734",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Menomonie, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.