Kassandra Kathleen Yarbrough

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

20043497A Issued in IN

Practice address

415 N 26TH St
Lafayette, IN 47904-2895

Phone

(765) 446-6573

NPI assigned

Oct 19, 2017

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

Other names 1

• Kassandra Moore-McIntyre Former name

Medicare fee-for-service enrollment

Enrolled in IN

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

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• Valley Oaks Health Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Lafayette, IN
  • NPI 1689629990
  Medicare reassignment NPD
• Good Fruit Counseling LLC

  • Psychologist
  • West Lafayette, IN
  • NPI 1639912041
  NPD
• Valley Oaks Health Inc

  • Federally Qualified Health Center (FQHC)
  • Lafayette, IN
  • NPI 1134901135
  NPD

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

{
    "created_epoch": "1508371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627257600000",
    "number": "1447761275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 N 26TH ST",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479042895",
            "telephone_number": "765-446-6573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 N 26TH ST",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479042895",
            "telephone_number": "765-446-6573"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 12th St",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958141956",
            "country_code": "US",
            "telephone_number": "209-329-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YARBROUGH",
        "first_name": "KASSANDRA",
        "middle_name": "KATHLEEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-19",
        "last_updated": "2021-07-26",
        "certification_date": "2021-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20043497A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KASSANDRA",
            "last_name": "MOORE-MCINTYRE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Xiaoyu Xia
• Jenny Xu
• Adel S. Yaacoub, MD
• Juhi Yadava, D.D.S.
• Joseph Michael E Yamamoto, M.D.
• Nina Yarijanian, PA-C
• Leonard Nsoyori Yenwongfai, MD
• Ashley Yeoman
• Kelsey Yerem, OTD, OTR
• Troy Brandon Yoakum

• Clinical Psychologist in Lafayette, IN
• Providers in Lafayette, IN by specialty
• Clinical Psychologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.