Individual provider Active NPI

Kathy W Zakarian, PSY.D.

  • Clinical Psychologist
  • Williamsport, PA
National Provider Identifier
1053481358
Registry record updated Jan 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS015696 Issued in PA
Practice address
1521 Washington Blvd
Williamsport, PA 17701-5426
Phone
(570) 322-5051
Fax
(570) 322-6788
NPI assigned
Nov 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PS015696 PA Primary
Psychologist 103T00000X

Addresses

Primary practice location

1521 Washington Blvd
Williamsport, PA 17701-5426

Mailing address

1521 Washington Blvd
Williamsport, PA 17701-5426
Phone (570) 322-5051

Other identifiers 1

IdentifierTypeStateIssuer
1928168OtherPAHIGHMARK BLUE SHIELD

Other names 1

  • Dr. Kathy S Wurster Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PS015696PAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484697600000",
    "number": "1053481358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1521 WASHINGTON BLVD",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177015426",
            "telephone_number": "570-322-5051",
            "fax_number": "570-322-6788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1521 WASHINGTON BLVD",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177015426",
            "telephone_number": "570-322-5051",
            "fax_number": "570-322-6788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAKARIAN",
        "first_name": "KATHY",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-08",
        "last_updated": "2017-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS015696",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "1928168",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHY",
            "last_name": "WURSTER",
            "middle_name": "S",
            "prefix": "DR.",
            "credential": "PSY.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Williamsport, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.