Stacey Lyn Van Grinsven, MS, CFY-SLP
NPI 1104018514ActiveIndividual· Speech-Language Pathologist· De Pere, WI
Speech-Language Pathologist (MS, CFY-SLP) in De Pere, Wisconsin, licensed in WI, with an NPI issued in August 2007. Enrolled in Medicare as practitioner - qualified speech language pathologist.
Overview
| NPI | 1104018514 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | MS, CFY-SLP |
| Sole proprietor | Yes |
| NPI issued | Aug 10, 2007 |
| Last updated in NPPES | Jan 18, 2024 |
| Certified by provider | Jan 18, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Speech-Language Pathologist Primary | 235Z00000X | 2953-154 | WI |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Qualified Speech Language Pathologist (WI) |
|---|
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All 36 speech-language pathologists in De Pere · All speech-language pathologists in Wisconsin