Individual provider Active NPI

Katherine Louise Hittel, PSYD

  • Clinical Psychologist
  • Tampa, FL
National Provider Identifier
1063772093
Registry record updated May 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY9243 Issued in FL
Practice address
3502 Henderson Blvd Ste 306
Tampa, FL 33609-3970
Phone
(813) 738-3898
Fax
(813) 642-4893
NPI assigned
May 23, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Clinical Psychologist 103TC0700X PY9243 FL Primary

Addresses

Primary practice location

3502 Henderson Blvd Ste 306
Tampa, FL 33609-3970

Mailing address

3502 Henderson Blvd Ste 306
Tampa, FL 33609-3970
Phone (813) 738-3898

Other names 1

  • Dr. Kate Louise Brereton Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Oct 1, 2024 through Oct 1, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PY9243FLMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
New Leaf Psychological Services, LLC Clinical CurrentSince May 7, 2024 Accepting new patients

Locations

3502 Henderson Blvd
Ste 306
Tampa, FL 33609
Phone (813) 738-3898

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1337731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714608000000",
    "number": "1063772093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3502 HENDERSON BLVD STE 306",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336093970",
            "telephone_number": "813-738-3898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3502 HENDERSON BLVD STE 306",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336093970",
            "telephone_number": "813-738-3898",
            "fax_number": "813-642-4893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HITTEL",
        "first_name": "KATHERINE",
        "middle_name": "LOUISE",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-23",
        "last_updated": "2024-05-02",
        "certification_date": "2024-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY9243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATE",
            "last_name": "BRERETON",
            "middle_name": "LOUISE",
            "prefix": "DR.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.