Individual provider Active NPI

Amber Karen Kuszak, PSY.D.

  • Clinical Psychologist
  • Williamsburg, VA
National Provider Identifier
1376831081
Registry record updated Mar 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
0810005665 Issued in VA
Practice address
202 Packets CT Ste a
Williamsburg, VA 23185-5862
Phone
(757) 659-6459
NPI assigned
Jul 14, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Clinical Psychologist 103TC0700X 0810005665 VA Primary

Addresses

Primary practice location

202 Packets CT Ste a
Williamsburg, VA 23185-5862

Mailing address

202 Packets CT Ste a
Williamsburg, VA 23185-5862
Phone (757) 659-6459

Other practice location 1

3671 Business Dr
Sacramento, CA 95820-2165
Phone (916) 734-4186

Other practice location 2

1657 Merrimac Trl
Williamsburg, VA 23185-5624
Phone (757) 220-3200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20170918003505 VA Practitioner - Clinical Psychologist 4183998925 Practice locations: Williamsburg, VA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

202 Packets CT
Suite a
Williamsburg, VA 23185-5629

202 Packets CT
Suite a
Williamsburg, VA 23185-5862
Phone (757) 659-6459

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0810005665VAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Beacon of Hope Psychological Services, LLC Clinical CurrentSince Mar 21, 2021 Accepting new patients
Colonial Behavioral Health PastSince Jul 10, 2017 Accepting new patients
Bridging the Gap Counseling Services PastSince Mar 21, 2021 Accepting new patients

Locations

202 Packets Ct
Ste A
Williamsburg, VA 23185
Phone (254) 368-0468

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1310601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615680000000",
    "number": "1376831081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 PACKETS CT STE A",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231855862",
            "telephone_number": "757-659-6459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 PACKETS CT STE A",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231855862",
            "telephone_number": "757-659-6459"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3671 Business Dr",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958202165",
            "country_code": "US",
            "telephone_number": "916-734-4186",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1657 Merrimac Trl",
            "address_purpose": "LOCATION",
            "city": "Williamsburg",
            "state": "VA",
            "postal_code": "231855624",
            "country_code": "US",
            "telephone_number": "757-220-3200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUSZAK",
        "first_name": "AMBER",
        "middle_name": "KAREN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-14",
        "last_updated": "2021-03-14",
        "certification_date": "2021-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810005665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsburg, VA

Sources for this page

Verify at the official NPI Registry.