KELSEY STANGE (NPI# 1407380116) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407380116 |
| Entity Type | Individual |
| Full Name | KELSEY STANGE |
| Other Name | KELSEY JOHNSTON |
| Credential | PSY.D. |
| Practice Address |
2925 Columbia Dr Portage WI 53901-9485 |
| Practice Telephone | 6087429100 |
| Enumeration Date | 2017-04-19 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
3323-57 | WI | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4439 Snowy Ridge Trl, Windsor, WI 535989694 | 3205831968 |
| Street Address |
2925 COLUMBIA DR |
| City | PORTAGE |
| State | WI |
| Zip Code | 53901-9485 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760522452 | Columbia Correctional Institution | Clinic/Center | 2925 Columbia Dr, Portage, WI 53901-9485 | 2007-02-08 |
| 1174712103 | Dalia Suliene | Internal Medicine | 2925 Columbia Dr, Portage, WI 53901-9485 | 2007-10-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740710748 | Robert James Corliss | Internal Medicine | St. Vincent Fmc, 140east Cook St., Portage, WI 53901 | 2017-06-13 |
| 1639328867 | Casey Jo Ambort | Speech-Language Pathologist | 626 East Slifer St, Portage, WI 53901 | 2008-09-11 |
| 1871767400 | Planned Parenthood of Wi, Inc | Non-Pharmacy Dispensing Site | 132 W. Cook St., Portage, WI 53901 | 2008-04-15 |
| 1881872158 | Marta Jean Jindra | Physical Therapist | 626 E Slifer Street, Portage, WI 53901 | 2008-02-08 |
| 1699953976 | Lana Marie Edwards | Speech-Language Pathologist | 626 East Slifer Street, Portage, WI 53901 | 2008-02-08 |
| 1134314552 | Kristina Hellenbrand | Physical Therapist | 2639 New Pinery Road, Suite 2, Portage, WI 53901 | 2007-09-10 |
| 1689727810 | Gregory Allan Bindl | Chiropractor | 2121new Pinery Rd, Portage, WI 53901 | 2007-01-19 |
| 1720149156 | Timothy J Rosin Dds Sc | Dentist | 2570 New Pinery Rd, Portage, WI 53901 | 2006-12-12 |
| 1710083779 | Currani Seubert Dental Office LLC | Dentist | 260 W Cook St, Portage, WI 53901 | 2006-09-16 |
| 1225090525 | University of Wisconsin Medical Foundation Inc | Durable Medical Equipment & Medical Supplies | 2977 Cty Hwy Cx, Portage, WI 53901 | 2006-04-04 |
| Find all providers in zip 53901 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083213631 | Robert J. Sheppard Phd Pllc | Psychologist | 8339 Brookwood Dr, Portage, MI 49024-5207 | 2020-10-23 |
| 1689965329 | Carolyn J Heineman Phd LLC | Psychologist | 5228 Lovers Ln, Suite 104, Portage, MI 49002-1521 | 2011-04-28 |
| 1609994029 | Robert Alan Rodenhiser | Psychologist | 1611 W Centre, Suite 203, Portage, MI 49024 | 2007-03-26 |
| 1497899801 | Susan Christine Baird | Psychologist | 8036 Moorsbridge Rd., Suite 2, Portage, MI 49024-4419 | 2007-02-18 |
| 1285702548 | David W. Parks | Psychologist | 6337 Central Ave, Portage, IN 46368-3801 | 2006-12-02 |
| 1720015985 | Joel Schwartz | Psychologist | 5877 Central Ave Ste A, Portage, IN 46368-2920 | 2006-06-26 |
| 1609837855 | Linda L Hill | Psychologist | 3141 Willowcreek Rd, Suite F, Portage, IN 46368-4468 | 2006-03-29 |
| 1215914304 | Steven Glen Townsend | Psychologist | 8928 Portage Rd, Portage, MI 49002-6420 | 2005-12-29 |
| 1558342030 | Patricia Moulton Guilford | Psychologist | 5930 Lovers Ln, Portage, MI 49002-1673 | 2005-11-10 |
| 1730176587 | John Michael Spores | Psychologist | 3349 Willowcreek Rd, Portage, IN 46368-5015 | 2005-10-05 |
| Find all providers in PORTAGE | ||||
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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.