Active NPI
Rita Vyacheclavovna Klyauzova
- Psychologist
- Wilmington, DE
National Provider Identifier
1447987169
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 965499
- Practice address
- 2625 Crossgates Dr.
Wilmington, DE 19808-2310 - Phone
- (302) 993-6415
- NPI assigned
- Aug 3, 2022
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 965499 | Primary |
Addresses
Primary practice location
2625 Crossgates Dr.
Wilmington, DE 19808-2310
Mailing address
2625 Crossgates Dr.
Wilmington, DE 19808-2310
Phone (302) 993-6415
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1659484800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1659484800000",
"number": "1447987169",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2625 CROSSGATES DR.",
"city": "WILMINGTON",
"state": "DE",
"postal_code": "198082310",
"telephone_number": "302-993-6415"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2625 CROSSGATES DR.",
"city": "WILMINGTON",
"state": "DE",
"postal_code": "198082310",
"telephone_number": "302-993-6415"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KLYAUZOVA",
"first_name": "RITA",
"middle_name": "VYACHECLAVOVNA",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-08-03",
"last_updated": "2022-08-03",
"certification_date": "2022-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": null,
"license": "965499",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wilmington, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.