Kathleen Clare Janusz, OTR, MED

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

120147 Issued in TX

Practice address

700 E State Highway 114
Southlake, TX 76092-5236

Phone

(682) 305-0657

NPI assigned

Aug 2, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Kathleen Clare Stack Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Education

State licenses

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

{
    "created_epoch": "1564704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564704000000",
    "number": "1366097735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 E STATE HIGHWAY 114",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760925236",
            "telephone_number": "682-305-0657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 E STATE HIGHWAY 114",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760925236",
            "telephone_number": "682-305-0657"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1080 W Round Grove Rd",
            "address_purpose": "LOCATION",
            "city": "Lewisville",
            "state": "TX",
            "postal_code": "750677903",
            "country_code": "US",
            "telephone_number": "469-203-4618",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JANUSZ",
        "first_name": "KATHLEEN",
        "middle_name": "CLARE",
        "name_prefix": "Mrs.",
        "credential": "OTR, MED",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-02",
        "last_updated": "2019-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "120147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "STACK",
            "middle_name": "CLARE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Richard Jackson, MD
• Mrudul Rajan Jagtap, OTR/L
• James Holt, DDS, PA
• Kevin Bernard James, M. D.
• Charla G Janecka, LPC-A
• Leigha Tate Jarzombek, PT, DPT
• Joseph Jasser, M.D.
• Carla Jauregui
• Jawad a Qureshi MD PA
• Dardhielle Jean, OTR/L

• Occupational Therapist in Southlake, TX
• Providers in Southlake, TX by specialty
• Occupational Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 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.

Verify at the official NPI Registry.