Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kim L Lasecki, PHD

Individual provider Clinical Child & Adolescent Psychologist · NPI 1235114513

Kim L Lasecki, PHD is a Clinical Psychologist in Green Bay, Wisconsin. Qualified in 2000, 26 years ago. Licensed in Wisconsin.

Years since qualifying
26
Licensed in
WI
In the registry since
2005
What do these letters mean?
PHD — Doctor of Philosophy
A research doctorate. In healthcare it usually sits alongside a clinical licence.

See every abbreviation used in this directory →

Practice location Address checks out

301 E Saint Joseph St
Green Bay, WI 54301-2241
Phone: (920) 433-6073
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Child & Adolescent Psychologist (primary) Taxonomy 103TC2200X · Licence 2448 (WI)

Record details

NPI number1235114513
Entity typeIndividual (Type 1)
GenderMale
Credentials PHD
Sole proprietorNo
NPI enumeratedDecember 9, 2005
Last updated in NPPESJuly 8, 2007

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 2000 (26 years in practice)
Accepts Medicare assignment Not indicated
Practice locations3 on file with Medicare

Other providers in Green Bay