Kathy Marie Carr, PH.D.
Individual provider Active NPI Psychologist · Van Wert, OH
NPI 1114287240 · NPPES record last updated Mar 29, 2013
Key facts
- NPI
- 1114287240
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychologist 103T00000X
- License
- 6909 (OH)
- Practice address
- 140 Fox Rd
Suite 303
Van Wert, OH 45891-2475 - Phone
- (419) 232-6010
- Fax
- (419) 232-6012
- NPI assigned
- May 23, 2012
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
105 W Court St
Van Wert, OH 45891-1723
Phone (419) 232-6010
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20121003000103 | OH | Practitioner - Clinical Psychologist | 5496904641 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6909 | OH | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Serenity Solutions, LLC | Psychologist | Current |
Accepting new patients |
| Kathryn H Bobbitt, LLC | Psychologist | Past | Accepting new patients |
Locations
140 Fox Rd
Ste 303
Van Wert, OH 45891
Phone (419) 232-6010
105 W Court St
Van Wert, OH 45891
Phone (419) 232-6010
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 6909 | OH | Yes |
Addresses
Primary practice location
140 Fox Rd
Suite 303
Van Wert, OH 45891-2475
Mailing address
140 Fox Rd
Suite 303
Van Wert, OH 45891-2475
Phone (419) 232-6010
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3810023991 | Medicaid | WV |
Other providers in Van Wert, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 29, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.