Rebecca Ann Smolak-Kettlehake, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

B1-0000893 Issued in DE

Practice address

200 Biddle Ave
Suite 105
Newark, DE 19702-3968

Phone

(302) 261-6901

NPI assigned

Feb 2, 2012

Last updated

Jun 23, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in DE

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

Specialty

Clinical Psychologist

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Rebecca Smolak-Kettlehake Psy D LLC

  • Clinical Psychologist
  • Newark, DE
  • NPI 1497134100
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1328140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719100800000",
    "number": "1255603593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 BIDDLE AVE STE 112",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197023982",
            "telephone_number": "302-261-6901",
            "fax_number": "302-365-6072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 BIDDLE AVE",
            "address_2": "SUITE 105",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197023968",
            "telephone_number": "302-261-6901"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Biddle Ave Ste 112",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "DE",
            "postal_code": "197023982",
            "country_code": "US",
            "telephone_number": "302-261-6901",
            "fax_number": "302-365-6072",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMOLAK-KETTLEHAKE",
        "first_name": "REBECCA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-02",
        "last_updated": "2024-06-23",
        "certification_date": "2024-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MD",
            "license": "05020",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "DE",
            "license": "B1-0000893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tanae Smith
• Taylor Olivia Smith
• Teri Lyn Smith, MSW/LCSW
• Tisha Michelle Smith, M.A.
• William Purnell Smith, D.D.S.
• Ryan Alexander Smolin, MD
• Abigail Rose Smucker
• Paul Anthony Smyser
• Gregory Snead, LCSW
• Janice D Sneed

• Psychologist in Newark, DE
• Providers in Newark, DE by specialty
• Psychologist in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.