Active NPI
Kimberly S D'Andrea, PSY.D.
- Clinical Psychologist
- Kingston, PA
National Provider Identifier
1275738718
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PS016214
- Practice address
- 517 Pierce Street
Kingston, PA 18704 - Phone
- (570) 829-2250
- Fax
- (570) 344-6699
- NPI assigned
- Jun 15, 2007
- 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 | PS016214 | PA | Primary |
Addresses
Primary practice location
517 Pierce Street
Kingston, PA 18704
Mailing address
204 Thackekay Close
Moosic, PA 18507
Phone (570) 814-7994
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS016214 | PA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181865600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1563494400000",
"number": "1275738718",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "204 THACKEKAY CLOSE",
"city": "MOOSIC",
"state": "PA",
"postal_code": "18507",
"telephone_number": "570-814-7994",
"fax_number": "570-344-6699"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "517 PIERCE STREET",
"city": "KINGSTON",
"state": "PA",
"postal_code": "18704",
"telephone_number": "570-829-2250",
"fax_number": "570-344-6699"
}
],
"practiceLocations": [],
"basic": {
"last_name": "D'ANDREA",
"first_name": "KIMBERLY",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-06-15",
"last_updated": "2019-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "PA",
"license": "PS016214",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kingston, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.