KIM L LASECKI (NPI# 1235114513) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235114513 |
| Entity Type | Individual |
| Full Name | KIM L LASECKI |
| Credential | PHD |
| Practice Address |
301 E Saint Joseph St Green Bay WI 54301-2241 |
| Practice Telephone | 9204336073 |
| Mailing Telephone | 9204336073 |
| Enumeration Date | 2005-12-09 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
2448 | WI | Behavioral Health & Social Service Providers |
| Street Address |
301 E SAINT JOSEPH ST |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54301-2241 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790775450 | Derek Carl Carlson | Psychiatry & Neurology | 301 E Saint Joseph St, Green Bay, WI 54301-2241 | 2005-10-25 |
| 1407486541 | Gabrielle Cassandra Jochman | Social Worker | 301 E Saint Joseph St, Green Bay, WI 54301-2241 | 2020-01-16 |
| 1457996910 | Jesse Frederick Peterson | Psychologist | 301 E Saint Joseph St, Green Bay, WI 54301-2241 | 2019-11-08 |
| 1528500626 | Yasleny Rodriguez-castillo | Nurse Practitioner | 301 E Saint Joseph St, Green Bay, WI 54301 | 2016-11-07 |
| 1992156210 | Kari Lynn Mahlik | Nurse Practitioner | 301 E Saint Joseph St, Green Bay, WI 54301-2241 | 2016-06-28 |
| 1710357900 | Erika Susanne Mangin | Registered Nurse | 301 E Saint Joseph St, Green Bay, WI 54301 | 2015-09-30 |
| 1972970572 | Kim Marie Smith | Counselor | 301 E Saint Joseph St, Green Bay, WI 54301-2241 | 2015-08-31 |
| 1104200286 | Meghan A Thompson | Counselor | 301 E Saint Joseph St, Green Bay, WI 54301-2241 | 2015-07-17 |
| 1720497118 | Mary Jo Vanden Wymelenberg | Counselor | 301 E Saint Joseph St, Green Bay, WI 54301-2241 | 2014-08-11 |
| 1811308836 | Ainsley E. Blum | Counselor | 301 E Saint Joseph St, Green Bay, WI 54301-2241 | 2014-05-13 |
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|---|---|---|---|---|
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| 1598229478 | Shaina Marie Conner | Registered Nurse | 835 S Vanburen St, Green Bay, WI 54301 | 2019-01-25 |
| 1093298960 | Brown County | Case Management | 111 N. Jefferson Street, Green Bay, WI 54301 | 2018-09-07 |
| 1639609928 | Frontline Healthcare LLC | Specialist/Technologist, Other | 2221 S. Webster Ave. Suite 270, Greenbay, WI 54301 | 2017-06-19 |
| 1992242606 | Charmaine Rimple | Counselor | 526 South Monroe Avenue, Green Bay, WI 54301 | 2017-01-20 |
| 1962944819 | Rebecca Lucille Reinbold | Registered Nurse | 917 Catherine Street, Green Bay, WI 54301 | 2016-11-09 |
| 1730635061 | Melissa Kristof | Specialist/Technologist, Other | 1821 Sounth Webster Ave., Green Bay, WI 54301 | 2016-08-28 |
| 1255709747 | Vivian Sweetheart Bishop-cook | Counselor | 2920 South Webster Ave, Green Bay, WI 54301 | 2015-09-14 |
| 1881079960 | Chelsi S Weber | Registered Nurse | 2300 Riverside Dr., Ste 204, Green Bay, WI 54301 | 2015-07-30 |
| 1962816371 | Joelle M Hesse | Counselor | 630 Cherry St., Green Bay, WI 54301 | 2014-06-13 |
| Find all providers in zip 54301 | ||||
| Taxonomy Code | 103TC2200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical Child & Adolescent |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376068379 | Monica L Gremillion | Psychologist | 9000 W Wisconsin Ave # Ms 958, Milwaukee, WI 53226-4874 | 2017-08-10 |
| 1861808412 | Jeffrey Karst | Psychologist | 8701 Watertown Plank Rd., Mfrc 3018, Medical College of Wisconsin Pediatric Hem/onc/bmt, Milwaukee, WI 53226 | 2014-07-03 |
| 1265634505 | Kimberly Arlene Young | Psychologist | 3505 N 124th St, Uppr, Brookfield, WI 53005-2489 | 2007-05-31 |
| 1073683413 | Amy M Schley | Psychologist | 204 Wisconsin Ave, Waukesha, WI 53186-4927 | 2006-11-09 |
| 1740229079 | Mary Margaret Rhoades | Psychologist | 5 Odana Ct, Madison, WI 53719-1120 | 2006-06-05 |
| 1861458093 | Anton C Smets | Psychologist | 101 N Farwell St Ste 204, Eau Claire, WI 54703-3767 | 2006-04-25 |
| 1265408173 | Marianne B Burton | Psychologist | 3610 Michelle Witmer Memorial Dr., New Berlin, WI 53151 | 2006-02-28 |
| 1003398868 | Megan Kay Higinbotham | Psychologist | 430 E Division St, Fond Du Lac, WI 54935-4597 | 2018-08-29 |
| 1134645724 | Kelsie-marie Offenwanger | Psychologist | 1000 N Oak Ave, Marshfield, WI 54449-5703 | 2017-08-16 |
| 1699155648 | Center for Language Acquisition and Social Skills Intervention, LLC | Psychologist | 8239 W Hillview Dr, Mequon, WI 53097-3205 | 2015-06-04 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.