Kirsten Montgomery Betak, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY 19719 Issued in CA

Practice address

Medical, Pcu GHW Bush Cvn77, Supship Newport News
4101 Washington Ave, BLDG 2
Newport News, VA 23607

Phone

(757) 534-1645

NPI assigned

Jan 16, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093867640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 KINDLEWOOD DR",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234556611",
            "telephone_number": "757-831-6246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MEDICAL, PCU GHW BUSH CVN77, SUPSHIP NEWPORT NEWS",
            "address_2": "4101 WASHINGTON AVE, BLDG 2",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "23607",
            "telephone_number": "757-534-1645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BETAK",
        "first_name": "KIRSTEN",
        "middle_name": "MONTGOMERY",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 19719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mulugeta W Berhe
• Matthew Stephen Berniard, M.D.
• Mary Wait Berry, N.P.
• Trina R Berry, NURSE PRACTITIONER
• Taylor Best
• Tiffany Yvonne Bethea
• Betone/Ledford Audiology & Hearing Aid Centers, Inc
• Chrystelle Ndedi Beyegue
• Beyond Disabilities, LLC
• Beyond Excellence, LLC

• Clinical Psychologist in Newport News, VA
• Providers in Newport News, VA by specialty
• Clinical Psychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.