NPIMap

Organization Active NPI

Insight Psychological Services, PLLC

  • Clinical Psychologist
  • Stafford, VA
National Provider Identifier
1437567161
Registry record updated Jul 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
0810004335 Issued in VA
Legal business name
INSIGHT PSYCHOLOGICAL SERVICES, PLLC
Practice address
2124 Jefferson Davis Hwy
Suite 102
Stafford, VA 22554-7264
Phone
(540) 419-2215
NPI assigned
Jul 25, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2014

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

Authorized official

Name
Dr. Kathryn Shaw, PSY.D.NPI 1629378476
Title
Member
Phone
(540) 419-2215

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 0810004335 VA Primary

Addresses

Primary practice location

2124 Jefferson Davis Hwy
Suite 102
Stafford, VA 22554-7264

Mailing address

2124 Jefferson Davis Hwy
Suite 102
Stafford, VA 22554-7264
Phone (540) 419-2215

Other identifiers 1

IdentifierTypeStateIssuer
1629378476MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151216002423 VA Part B Supplier - Clinic/Group Practice 8729389739 Receives reassigned benefits from 5 practitioners
Practice locations: Stafford, VA

National Provider Directory

National Provider Directory
Tax ID family
Insight Psychological Services PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2126 Richmond Hwy
Stafford, VA 22554

2126 Richmond Hwy
Ste 103
Stafford, VA 22554
Phone (540) 658-0888

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1406246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406246400000",
    "number": "1437567161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2124 JEFFERSON DAVIS HWY",
            "address_2": "SUITE 102",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "225547264",
            "telephone_number": "540-419-2215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2124 JEFFERSON DAVIS HWY",
            "address_2": "SUITE 102",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "225547264",
            "telephone_number": "540-419-2215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INSIGHT PSYCHOLOGICAL SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-25",
        "last_updated": "2014-07-25",
        "status": "A",
        "authorized_official_last_name": "SHAW",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "540-419-2215",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810004335",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1629378476",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stafford, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.