Individual provider Active NPI

Kristin M Talka, PSYCHOLOGIST

  • Clinical Psychologist
  • Kingston, NY
National Provider Identifier
1235379926
Registry record updated Apr 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
018036 Issued in NY
Practice address
44 Main St
Kingston, NY 12401-3828
Phone
(518) 956-3902
NPI assigned
Feb 20, 2009
Last updated
Apr 26, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 26, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X PS1254 ME
Clinical Psychologist 103TC0700X 018036 NY Primary

Addresses

Primary practice location

44 Main St
Kingston, NY 12401-3828

Mailing address

127 Lounsbury PL
Kingston, NY 12401-5254
Phone (518) 956-3902

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110427000647 NY Practitioner - Clinical Psychologist 7214087030 Practice locations: Kingston, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

192 Pine St
Kingston, NY 12401-4528
Phone (518) 956-3902

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PS1254MEMDClinical Neuropsychologist
018036NYMDClinical Psychologist
0180361NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Che Senior Psychological Services, PC Clinical PastSince Feb 2, 2020 Accepting new patients
David M Hansen PHD Past Accepting new patients

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1235088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556236800000",
    "number": "1235379926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 LOUNSBURY PL",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124015254",
            "telephone_number": "518-956-3902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 MAIN ST",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124013828",
            "telephone_number": "518-956-3902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TALKA",
        "first_name": "KRISTIN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PSYCHOLOGIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-20",
        "last_updated": "2019-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "ME",
            "license": "PS1254",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "018036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingston, NY

Sources for this page

Verify at the official NPI Registry.