Stephanie R Raszkiewicz, PHD, CSAC

Primary specialty

PsychologistTaxonomy code 103T00000X

License

3002-57 Issued in WI

Practice address

316 5TH St Ste 2
Racine, WI 53403-4606

Phone

(262) 308-8085

Fax

(262) 364-3679

NPI assigned

May 2, 2008

Last updated

Jan 26, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

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.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2010

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Dynamic Potential

  • Counseling Psychologist
  • Racine, WI
  • NPI 1023656162
  Medicare reassignment NPD Authorized official
• Racine Psychological Services, Inc.

  • Adult Mental Health Clinic/Center
  • Racine, WI
  • NPI 1275586323
  NPD (past)

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

{
    "created_epoch": "1209686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674691200000",
    "number": "1952577629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1943",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531411943",
            "telephone_number": "262-308-8085",
            "fax_number": "262-364-3679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 5TH ST STE 2",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534034606",
            "telephone_number": "262-308-8085",
            "fax_number": "262-364-3679"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1717 Taylor Ave",
            "address_purpose": "LOCATION",
            "city": "Racine",
            "state": "WI",
            "postal_code": "53403",
            "country_code": "US",
            "telephone_number": "262-638-6744",
            "fax_number": "262-638-6540",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RASZKIEWICZ",
        "first_name": "STEPHANIE",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "PHD, CSAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-02",
        "last_updated": "2023-01-26",
        "certification_date": "2023-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "15310-132",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "3002-57",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40968000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Racine Unified School District
• Chloe Marie Ragland, NP
• Laura Ramos, LPC
• Sammy Joe Rangel, CSAC
• Kathleen Rasmussen, LPC
• Shalini Ravi, MD
• Recovery Medical Transport (Kurt L Kowalski)
• Crystal J Reese
• David Ramon Reesman, D.D.S.
• Emily Manago Reisman, LPN

• Psychologist in Racine, WI
• Providers in Racine, WI by specialty
• Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2023; 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.