Active NPI
Karen Vanderbilt, PHD
- Clinical Psychologist
- Langley, WA
National Provider Identifier
1144317561
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 938
- Practice address
- 919 3Rd St
Suite 101
Langley, WA 98260-9228 - Phone
- (360) 221-5603
- Fax
- (360) 221-2515
- NPI assigned
- Oct 6, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 938 | WA | Primary |
Addresses
Primary practice location
919 3Rd St
Suite 101
Langley, WA 98260-9228
Mailing address
919 3Rd St
Suite 101
Langley, WA 98260-9228
Phone (360) 221-5603
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 938 | WA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160092800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1144317561",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "919 3RD ST",
"address_2": "SUITE 101",
"city": "LANGLEY",
"state": "WA",
"postal_code": "982609228",
"telephone_number": "360-221-5603",
"fax_number": "360-221-2515"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "919 3RD ST",
"address_2": "SUITE 101",
"city": "LANGLEY",
"state": "WA",
"postal_code": "982609228",
"telephone_number": "360-221-5603",
"fax_number": "360-221-2515"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANDERBILT",
"first_name": "KAREN",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WA",
"license": "938",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Langley, WA
Sources for this page
- 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.