INSIDE OUT COUNSELING AND DIAGNOSTIC CENTER, LLC (NPI# 1366567174) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366567174 |
| Entity Type | Organization |
| Organization Name | INSIDE OUT COUNSELING AND DIAGNOSTIC CENTER, LLC |
| Practice Address |
104 S Main St Suite 711 Fond Du Lac WI 54935-4269 |
| Practice Telephone | 9203229100 |
| Practice Fax Number | 9203229493 |
| Mailing Telephone | 9203229100 |
| Mailing Fax Number | 9203229493 |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. PEGGY A DENNISON (OWNER) |
| Authorized Official Telephone | 9203229100 |
| Authorized Official Credential | PHD. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | 2394-057 | WI | Behavioral Health & Social Service Providers |
| Street Address |
104 S MAIN ST SUITE 711 |
| City | FOND DU LAC |
| State | WI |
| Zip Code | 54935-4269 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609482249 | Keziah Sherri Love | Counselor | W390 Wi-23, Fond Du Lac, WI 54935 | 2020-09-18 |
| 1891341988 | Cynthia Louise Singleton | Nurse Practitioner | 16 E 13th St., Fond Du Lac, WI 54935 | 2019-08-14 |
| 1083183297 | Elena Alexandra Giese | Nurse Practitioner | 430 E. Division St, Fond Du Lac, WI 54935 | 2018-11-16 |
| 1669963740 | Elizabeth Anne Machi | Student in an Organized Health Care Education/Training Program | 885 Western Ave Ste 300, Fond Du Lac, WI 54935 | 2018-05-23 |
| 1184150021 | Jordan Moehn | Specialist/Technologist | 633 Prairie Pkwy, Fond Du Lac, WI 54935 | 2017-05-11 |
| 1467856336 | Chuentao Ho | Specialist/Technologist | 45 South National Ave., Fond Du Lac, WI 54935 | 2014-10-21 |
| 1437587961 | Paula Seeley | Nurse Practitioner | 63 West Pioneer Rd, Fond Du Lac, WI 54935 | 2013-10-18 |
| 1144516030 | Bonnie Kay Mallon | Registered Nurse | 118 E 9th St, Fond Du Lac, WI 54935 | 2011-06-20 |
| 1770885600 | Holly Shepard | Counselor | 23 W Scott St., Fond Du Lac, WI 54935 | 2010-11-29 |
| 1437479110 | Ruth Marie Bohn | Occupational Therapy Assistant | 244 North Macy Street, Fond Du Lac, WI 54935 | 2010-06-04 |
| Find all providers in zip 54935 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790132793 | Amber Nicole Hall | Psychologist | 430 E Division St, Fond Du Lac, WI 54935-4560 | 2016-05-19 |
| 1235508748 | Abigail Ida Ruh | Psychologist | 430 E Division St, Fond Du Lac, WI 54935-4560 | 2015-09-15 |
| 1326330291 | Teri L. Kaczmarek | Psychologist | 210 Wisconsin American Dr, Fond Du Lac, WI 54937-2999 | 2011-05-10 |
| 1013100684 | Espen Klausen | Psychologist | 459 E 1st St, Fond Du Lac, WI 54935-4505 | 2007-08-27 |
| 1831300508 | Jennifer L Specht | Psychologist | 430 E Division St, Fond Du Lac, WI 54935-4560 | 2007-05-24 |
| 1518184910 | Marianne Niles | Psychologist | 459 E 1st St, Fond Du Lac, WI 54935-4505 | 2007-04-19 |
| 1396960340 | Kristine Nehring | Psychologist | 459 E 1st St, Fond Du Lac, WI 54935-4505 | 2007-04-16 |
| 1285859678 | Joseph Haney | Psychologist | 459 E 1st St, Fond Du Lac, WI 54935-4505 | 2007-04-13 |
| 1669697082 | Stephen Holstein | Psychologist | 459 E 1st St, Fond Du Lac, WI 54935-4505 | 2007-04-13 |
| 1629088018 | James L Salasek | Psychologist | 430 E Division St, Fond Du Lac, WI 54935-4560 | 2006-08-08 |
| Find all providers in FOND DU LAC | ||||
| City | FOND DU LAC |
| Zip Code | 54935 |
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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.