KATHERINE WOUDSTRA – Psychologist, NPI 1265128508

KATHERINE WOUDSTRA is a healthcare provider. based in Allendale, Michigan. specializing in CLINICAL PSYCHOLOGIST. The NPI Number for KATHERINE WOUDSTRA is 1265128508

Main info

Female
3 Years Of Experience
Accepts Medicare Assignment
Name
KATHERINE WOUDSTRA
NPI
1265128508
Phone
(954) 707-2864
Address
6499 HENRY ST
Enumeration Date
11 April 2023
Last Update Date
11 April 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6053342696
Graduation Year
2023 (3 years ago)
PAC ID
1456885771
Group Practice PAC ID
8628979721
Professional Enrollment ID
I20241108003374
Address ID
SD571053730SI2109XAVEX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:3State licenses:0Digital endpointsOther names

75 CLINICAL PSYCHOLOGIST in SD

Provider Addresses for KATHERINE WOUDSTRA

  • 6499 HENRY ST

    ALLENDALE, MI 494018423

    Phone: (954) 707-2864

    Type: Mailing

  • 2109 S NORTON AVE

    SIOUX FALLS, SD 571053730

    Phone: (605) 334-2696

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-11-08

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20241108003374IClinical PsychologistSDTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 49401)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8628979721View full group profile
NameSpecialtyState
Clinical PsychologistSD
Marriage And Family TherapistSD
Marriage And Family TherapistSD
Mental Health CounselorSD
Mental Health CounselorSD
Marriage And Family TherapistSD
Mental Health CounselorSD
Mental Health CounselorSD
Marriage And Family TherapistSD
Mental Health CounselorSD

Reviews

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Frequently asked questions

How do I look up KATHERINE WOUDSTRA by NPI?
Use NPI 1265128508 when you need to reference KATHERINE WOUDSTRA in forms, claims, or directories.
Is KATHERINE WOUDSTRA's enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Can you summarize KATHERINE WOUDSTRA's specialty in plain language?
Clinically, the directory lists KATHERINE WOUDSTRA with Psychologist. Clinical services aligned with this taxonomy classification.
Where does public data place KATHERINE WOUDSTRA?
The snapshot lists Allendale, Michigan for KATHERINE WOUDSTRA; download NPPES for the complete set.
What if Allendale, Michigan seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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