Dynamic Potential in Racine, WI - Medicare Psychologist

Dynamic Potential is a medicare enrolled mental health clinic (Psychologist - Counseling) in Racine, Wisconsin. The current practice location for Dynamic Potential is 316 5th St Ste 2, Racine, Wisconsin. For appointments, you can reach them via phone at (262) 308-8085. The mailing address for Dynamic Potential is Po Box 1943, Kenosha, Wisconsin and phone number is (262) 308-8085.

Dynamic Potential is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1023656162. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (262) 308-8085.

Contact Information

	Dynamic Potential
	316 5th St Ste 2 Racine WI 53403-4606
	(262) 308-8085
	Not Available

Map and Direction

Mental Health Clinic Profile

Full Name	Dynamic Potential
Speciality	Psychologist
Location	316 5th St Ste 2, Racine, Wisconsin
Authorized Official Name and Position	Stephanie R Raszkiewicz (LICENSED PSYCHOLOGIST)
Authorized Official Contact	2623088085
Accepts Medicare Insurance	Yes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Dynamic Potential Po Box 1943 Kenosha WI 53141-1943 Ph: (262) 308-8085	Dynamic Potential 316 5th St Ste 2 Racine WI 53403-4606 Ph: (262) 308-8085

NPI Details:

NPI Number	1023656162
Provider Enumeration Date	12/19/2019
Last Update Date	02/24/2020
Certification Date	02/24/2020

Medicare PECOS Information:

Medicare PECOS PAC ID	4183051683
Medicare Enrollment ID	O20200221002584

Medical Identifiers

Medical identifiers for Dynamic Potential such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1023656162	NPI	-	NPPES
40968000	Medicaid	WI

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103TA0400X	Psychologist - Addiction (substance Use Disorder)	(* (Not Available))	Secondary
103TC1900X	Psychologist - Counseling	(* (Not Available))	Primary
103TF0000X	Psychologist - Family	(* (Not Available))	Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Dynamic Potential acts as a billing entity for following providers:

Provider Name	Stephanie Raszkiewicz
Provider Type	Practitioner - Clinical Psychologist
Provider Identifiers	NPI Number: 1952577629 PECOS PAC ID: 2466608708 Enrollment ID: I20120802000093

Reviews and Comments

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Dynamic Potential - Medicare Mental Health Clinic in Racine, WI