Active NPI
Katherine Havlik, PHD, LP
- Psychologist
- Salt Lake City, UT
National Provider Identifier
1164089520
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 12015949-2501
- Practice address
- 501 S Chipeta Way
Salt Lake City, UT 84108-1222 - Phone
- (801) 583-2500
- NPI assigned
- May 21, 2019
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 12015949-2501 | UT | Primary |
Addresses
Primary practice location
501 S Chipeta Way
Salt Lake City, UT 84108-1222
Mailing address
501 S Chipeta Way
Salt Lake City, UT 84108-1222
Phone (015) 832-5008
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | khavlik89692@direct.med.utah.edu | Direct | UNIVERSITY OF UTAH |
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 |
|---|---|---|---|
| 12015949-2501 | UT | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1558396800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635897600000",
"number": "1164089520",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "501 S CHIPETA WAY",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841081222",
"telephone_number": "015-832-5008"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 S CHIPETA WAY",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841081222",
"telephone_number": "801-583-2500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAVLIK",
"first_name": "KATHERINE",
"credential": "PHD, LP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-05-21",
"last_updated": "2021-11-03",
"certification_date": "2021-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "UT",
"license": "12015949-2501",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "khavlik89692@direct.med.utah.edu",
"affiliation": "Y",
"affiliationName": "UNIVERSITY OF UTAH",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CDA/CCD/TXT",
"address_1": "50 N Medical Dr",
"city": "Salt Lake City",
"state": "UT",
"country_code": "US",
"postal_code": "841320001",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Salt Lake City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.