CCP CLINIC, LLC
NPI 1396431714
Psychologist - Clinical in De Pere, WI
About Ccp Clinic, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
CCP CLINIC, LLC (NPI 1396431714) is a healthcare organization registered as a clinical in De Pere, Wisconsin and active in the NPI registry since April 2023. The organization maintains 3 additional practice locations and lists Jaclyn Geitner, Co-owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 3
Secondary Practice Locations 3
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Ccp Clinic, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
29Medicare enrollment records show 29 clinicians reassign Medicare billing to Ccp Clinic, LLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 8 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 4
Nearest to this location (20)
See all 29Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Ccp Clinic, LLC's NPI number?
The NPI number for Ccp Clinic, LLC is 1396431714. It was assigned to this organization in the NPPES registry on April 18, 2023.
Where is Ccp Clinic, LLC located?
Ccp Clinic, LLC is located at 3301 Packerland Dr Ste B, De Pere, WI 54115. The listed phone number is (920) 234-9240.
What is Ccp Clinic, LLC's specialty?
The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.
Is Ccp Clinic, LLC enrolled in Medicare?
Yes. Ccp Clinic, LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Ccp Clinic, LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 29 clinicians in 4 Medicare specialties reassign their Medicare billing to Ccp Clinic, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Mental Health Counselor (16), Clinical Social Worker (11) and Clinical Psychologist (1). Of these, 1 practice at this address and 8 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Ccp Clinic, LLC accept?
Health plans from Anthem Blue Cross and Blue Shield, Aspirus Health Plan, CareSource (Common Ground Healthcare), HealthPartners and Quartz and 1 other insurer list Ccp Clinic, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Ccp Clinic, LLC was last updated on April 3, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 months 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.
# Ccp Clinic, Llc · NPI 1396431714
Clinical organization in De Pere, Wisconsin. Organization record, active in the CMS NPPES registry since April 18, 2023.
## Identity
- **NPI:** 1396431714 (Entity type: Organization)
- **Enumerated:** April 18, 2023
- **Primary specialty:** Psychologist - Clinical · taxonomy 103TC0700X
- **Organization subpart:** No
- **Authorized official:** Jaclyn Geitner, CO-OWNER
## Practice location
- **Address:** 3301 PACKERLAND DR STE B, De Pere, WI 54115-9533
- **Phone:** (920) 234-9240
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 29 clinicians in 4 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Mental Health Counselor (16), Clinical Social Worker (11), Clinical Psychologist (1); 1 practice at this address and 8 within 10 miles; [full list](https://npiprofile.com/npi/1396431714/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** April 3, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1396431714) · Data from the CMS NPPES public registry.