Ccp Clinic, LLC
NPI 1396431714 · Clinical Psychologist · De Pere, WI
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Ccp Clinic, LLC is a Clinical Psychologist organization in De Pere, WI (NPI 1396431714).
Provider details
- NPI number
- 1396431714
- Entity type
- Organization
- Primary specialty
- Clinical PsychologistBehavioral Health & Social Service Providers
- Organization subpart
- No
- Authorized official
- Jaclyn Geitner, Co-Owner(651) 491-1346
Specialties & taxonomies
Behavioral Health & Social Service Providers
- Professional Counselor101YP2500X
Behavioral Health & Social Service Providers
- Clinical Social Worker1041C0700X
Behavioral Health & Social Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
3 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
4 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Additional practice locations (3)
- 424 E Longview DrAppleton, WI 54911-2167Phone: (920) 234-9240Fax: (920) 364-6096
- 3301 N Ballard Rd Ste CAppleton, WI 54911-9002Phone: (920) 234-9240Fax: (920) 364-6096
- 9000 W Chester St Ste 100Milwaukee, WI 53214-1372Phone: (920) 234-9240Fax: (920) 364-6096
Registry dates
- Enumerated
- 2023-04-18
- Last updated
- 2025-04-03
- Certified
- 2025-03-29
Frequently asked questions
- What is Ccp Clinic, LLC's NPI number?
- Ccp Clinic, LLC's National Provider Identifier (NPI) is 1396431714, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Ccp Clinic, LLC?
- Ccp Clinic, LLC is classified in the NPPES registry as Clinical Psychologist (Behavioral Health & Social Service Providers).
- Where is Ccp Clinic, LLC located?
- Ccp Clinic, LLC's practice location on file with NPPES is 3301 Packerland Dr Ste B, De Pere, WI 54115-9533.
- What is Ccp Clinic, LLC's phone number?
- The practice phone number listed in the NPPES registry for Ccp Clinic, LLC is (920) 234-9240.
- Does Ccp Clinic, LLC accept Medicare?
- Ccp Clinic, LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Ccp Clinic, LLC?
- The authorized official listed on Ccp Clinic, LLC's NPPES record is Jaclyn Geitner, Co-Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Ccp Clinic, LLC's NPI active?
- Yes — Ccp Clinic, LLC's NPI (1396431714) is active in the NPPES registry as of the last update on 2025-04-03.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.