KIM L LASECKI PHD
NPI 1235114513
Psychologist - Clinical Child & Adolescent in Green Bay, WI

Q: What is Kim Lasecki's NPI number?

The NPI number for Kim Lasecki is 1235114513. It was assigned to this individual provider in the NPPES registry on December 9, 2005.

Q: What is Kim Lasecki's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical Child & Adolescent, with taxonomy code 103TC2200X.

Q: When was this NPI record last updated?

The NPPES record for Kim Lasecki was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since December 09, 2005PECOS Enrolled

301 E SAINT JOSEPH ST, GREEN BAY, WI 54301(920) 433-6073 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Kim L Lasecki Phd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KIM L LASECKI PHD (NPI 1235114513) is an individual clinical child & adolescent provider in Green Bay, Wisconsin, licensed in Wisconsin (2448) and active in the NPI registry since December 2005. He is enrolled in Medicare PECOS and is a graduate of Other (2000).

NPPES Registry Identity

NPI1235114513

Entity TypeIndividualMale

Primary Taxonomy103TC2200X

Provider Legal NameKIM L LASECKICredential: PHD

Location Address301 E SAINT JOSEPH STGreen Bay, WI 54301-2241

Mailing Address301 E Saint Joseph StGreen Bay, WI 54301-2241 · (920) 433-6073

Phone(920) 433-6073

Sole ProprietorNo

Medical School CMSOtherGraduated 2000

Enumeration DateDecember 9, 2005

Last NPPES UpdateJuly 8, 2007

✔ NPI 1235114513 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · Clinical Child & AdolescentBehavioral Health & Social Service Providers

Taxonomy Code103TC2200X

License✔ Licensed in WI · 2448

Definition

A psychologist who develops and applies scientific knowledge to the delivery of psychological services to infants, toddlers, children and adolescents within their social context. Of particular importance to the specialty of clinical child psychology is an understanding of the basic psychological needs of children and adolescents, and how the family and other social contexts influence the socio-emotional adjustment, cognitive development, behavioral adaptation and health status of children and adolescents.

301 E SAINT JOSEPH ST, Green Bay, WI 54301

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Aspirus Health Plan, CareSource (Common Ground Healthcare) and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kim L Lasecki Phd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID2365334612

PECOS Enrollment IDI20250728000409

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. EMILY R RADEMACHER D.O., M.B.A.

Psychiatry & Neurology (Psychiatry)