Benjamin de Boer PSYD LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

BENJAMIN DE BOER PSYD LLC

Practice address

2916 Marketplace Dr.
Suite 206 & 207
Fitchburg, WI 53719

Phone

(608) 886-9697

NPI assigned

Jul 1, 2024

Organization subpart

No

Name

Benjamin I De Boer, PSYDNPI 1659057446

Title

Owner

Phone

(608) 886-9697

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Benjamin I De Boer, PSYD

  • Clinical Psychologist
  • Fitchburg, WI
  • NPI 1659057446

  Clinical

  NPD Authorized official

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 18, 2026.

{
    "created_epoch": "1719792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768694400000",
    "number": "1992540876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 E ENTERPRISE AVE STE 333",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549137889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2916 MARKETPLACE DR.",
            "address_2": "SUITE 206 & 207",
            "city": "FITCHBURG",
            "state": "WI",
            "postal_code": "53719",
            "telephone_number": "608-886-9697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BENJAMIN DE BOER PSYD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-01",
        "last_updated": "2026-01-18",
        "certification_date": "2026-01-18",
        "status": "A",
        "authorized_official_last_name": "DE BOER",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "608-886-9697",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shelby Elizabeth Beckman, OTD, OTR/L
• Philip S Bedrossian, MD
• Katelyn D Beemon, APNP
• Bianca Bellissimo, PHARMD
• Candace Marie Bender, RN
• Rita A Berge, RDH
• Olivia Bergman, M.S., CCC-SLP
• Bergmann'S Inc
• Bergmanns Inc.
• Patrick Bertz, FNP

• All providers in Fitchburg, WI
• Clinical Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 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.

Verify at the official NPI Registry.