Individual provider Active NPI

Kathleen S. Berkey, M.A., M.S.

  • Clinical Psychologist
  • Meadville, PA
National Provider Identifier
1003886656
Registry record updated Jan 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS016996 Issued in PA
Practice address
18201 Conneaut Lake Rd
Meadville, PA 16335-3757
Phone
(814) 333-5060
Fax
(814) 333-5057
NPI assigned
Jan 25, 2006
Last updated
Jan 7, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X PC001895 PA
Clinical Psychologist 103TC0700X PS016996 PA Primary

Addresses

Primary practice location

18201 Conneaut Lake Rd
Meadville, PA 16335-3757

Mailing address

1034 Grove St
Meadville, PA 16335-2945
Phone (814) 333-5060

Other identifiers 1

IdentifierTypeStateIssuer
1022563030003MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110801000564 PA Practitioner - Clinical Psychologist 1951570365 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Meadville Medical CenterGroup PAC ID 4284535790, 139 clinicians

Practice addresses (Care Compare)

18201 Conneaut Lake Rd
Meadville, PA 16335-3757
Phone (814) 333-5060

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts, Master of Science, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PC001895PAMDProfessional Counselor
PS016996PAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Meadville Medical Center Professional Current Accepting new patients
Meadville Medical Center CurrentSince May 14, 2011 Accepting new patients
Meadville Medical Center CurrentSince May 14, 2011 Accepting new patients

Locations

1034 Grove St
Meadville, PA 16335
Phone (814) 333-5728

18201 Conneaut Lake Rd
Meadville, PA 16335
Phone (814) 333-5060

751 Liberty St
Meadville, PA 16335
Phone (814) 333-5081

Networks

  • devoted network organization-8ee96498-f86e-45f6-9fc9-a0f06c1636f9
  • devoted network organization-2d523d8e-e8f9-454a-bcd3-333df65bdbe8
  • devoted network organization-598bd2d4-c652-473f-ba7a-132f674c8eb6
  • devoted network organization-9f3dfbd3-4aa6-4c92-8e71-9c4ed35ce037
  • OH PPO

Interoperability endpoints

  • Direct secure messaging: kathleen.berkey@directaddress.net

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420588800000",
    "number": "1003886656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1034 GROVE ST",
            "city": "MEADVILLE",
            "state": "PA",
            "postal_code": "163352945",
            "telephone_number": "814-333-5060",
            "fax_number": "814-333-5067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18201 CONNEAUT LAKE RD",
            "city": "MEADVILLE",
            "state": "PA",
            "postal_code": "163353757",
            "telephone_number": "814-333-5060",
            "fax_number": "814-333-5057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERKEY",
        "first_name": "KATHLEEN",
        "middle_name": "S.",
        "name_prefix": "Ms.",
        "credential": "M.A., M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-25",
        "last_updated": "2015-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC001895",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS016996",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1022563030003",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Meadville, PA

Sources for this page

Verify at the official NPI Registry.