DR. SHELLIE DEE LOCKE (NPI# 1336319979) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336319979 |
| Entity Type | Individual |
| Full Name | DR. SHELLIE DEE LOCKE |
| Credential | PH.D. |
| Practice Address |
9020 15th Ave Kenosha WI 53143-6803 |
| Practice Telephone | 7082247442 |
| Mailing Telephone | 7082247442 |
| Enumeration Date | 2008-03-11 |
| Last Update Date | 2008-03-11 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103G00000X | Clinical Neuropsychologist | 071.007310 | IL | Behavioral Health & Social Service Providers |
| N | 103G00000X | Clinical Neuropsychologist | 2660-057 | WI | Behavioral Health & Social Service Providers |
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
071.007310 | IL | Behavioral Health & Social Service Providers |
| N | 103TC0700X |
Psychologist Specialization: Clinical |
2660-057 | WI | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 40994300 | 05 |
| Street Address |
9020 15TH AVE |
| City | KENOSHA |
| State | WI |
| Zip Code | 53143-6803 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184894628 | Locke Consulting Services Company | Community/Behavioral Health | 9020 15th Ave, Kenosha, WI 53143-6803 | 2008-03-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891262275 | Shanda L Goecks | Registered Nurse | 6916 26th Ave, Kenosha, WI 53143 | 2018-10-24 |
| 1689942989 | Racine Kenosha Community Action Agency | Public Health or Welfare | 2000 63rd Street, Kenosha, WI 53143 | 2011-12-01 |
| 1538497797 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 7525 Sheridan Rd, Kenosha, WI 53143 | 2009-11-30 |
| 1497929012 | Ebba M Johnson | Physical Therapist | 524 74th Street, Kenosha, WI 53143 | 2008-04-15 |
| 1770789489 | Kenosha Community Health Center, Inc | Family Medicine | 6226 14th Ave, Kenosha, WI 53143 | 2007-06-21 |
| 1558413161 | Junith M Thompson | Obstetrics & Gynecology | 6530 Sheridan Road, Kenosha, WI 53143 | 2007-01-17 |
| 1154471332 | Ljh Ambulance, Inc | Ambulance | 6329 28th Ave, Kenosha, WI 53143 | 2007-01-11 |
| 1578625794 | Michael A Schellpfeffer Md Ob Gyn Sc | Obstetrics & Gynecology | 1400 75th Street, Kenosha, WI 53143 | 2006-12-14 |
| 1457468654 | Yasmine S Sido | Physician Assistant | 7550 22nd Ave, Kenosha, WI 53143 | 2006-08-24 |
| 1356307359 | Nancy Jane Houtchens | Dentist | 7533 22nd Ave, Ste 100, Kenosha, WI 53143 | 2006-04-26 |
| Find all providers in zip 53143 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558619379 | Leah J Featherstone | Psychologist | 2108-63 Street, Kenosha, WI 53143-4454 | 2012-08-28 |
| 1336412360 | Kristin M Keeler, S.c | Psychologist | 4217 Green Bay Rd, Kenosha, WI 53144-4518 | 2012-02-22 |
| 1497957724 | Janice Alberdiena Vanniel | Psychologist | 7807 15th Ave, Kenosha, WI 53143-5913 | 2007-05-31 |
| 1821345372 | Dana Michelle Ballewske | Psychologist | 2108 63rd St, Kenosha, WI 53143-4454 | 2012-08-14 |
| 1124213954 | Michael Matthew Mihajlovic | Psychologist | 4536 22nd Ave, Kenosha, WI 53140-5917 | 2007-09-14 |
| 1487868584 | Kristin Marie Keeler | Psychologist | 5024 Green Bay Rd, Suite 120, Kenosha, WI 53144-1702 | 2007-05-09 |
| 1780769810 | Verna F. Christy | Psychologist | 5017 Green Bay Rd Ste 130, Kenosha, WI 53144-1782 | 2006-10-26 |
| 1467537423 | Debra Johansen | Psychologist | 6121 Green Bay Rd, Suite 230, Kenosha, WI 53142-2926 | 2006-10-26 |
| 1952482267 | Leesa Marie Wiedholz-abbott | Psychologist | 3734 7th Ave, Suite 12, Kenosha, WI 53140-5525 | 2006-10-17 |
| 1649291923 | Kalpana Rao | Psychologist | 6123 Green Bay Rd, Kenosha, WI 53142-2927 | 2006-07-21 |
| Find all providers in KENOSHA | ||||
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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.