Individual provider Active NPI

Kathy Marie Van Stone, PSY.D

  • Clinical Psychologist
  • Cedar Park, TX
National Provider Identifier
1467583419
Registry record updated Dec 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
35086 Issued in TX
Practice address
3000 Polar LN Ste 101
Cedar Park, TX 78613-3065
Phone
(844) 824-8775
NPI assigned
Mar 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY19357 CA
Psychologist 103T00000X 35086 TX
Health Service Psychologist 103TH0100X PSY19357 CA
Clinical Psychologist 103TC0700X 35086 TX Primary

Addresses

Primary practice location

3000 Polar LN Ste 101
Cedar Park, TX 78613-3065

Mailing address

3000 Polar LN Ste 101
Cedar Park, TX 78613-3065
Phone (844) 824-8775

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20110830000412 TX Practitioner - Clinical Psychologist 9436041498 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Progressive Behavioral Health, PLLCGroup PAC ID 4486794906, 366 clinicians

Practice addresses (Care Compare)

3000 Polar LN
Suite 101
Cedar Park, TX 78613-3065
Phone (844) 824-8775

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
35086TXMDClinical Psychologist
PSY19357CAMDHealth Service Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Vista Medical Partners a Professional Corporation CurrentSince Feb 2, 2004 Accepting new patients
Progressive Behavioral Health, PLLC Clinical CurrentSince Nov 1, 2024 Accepting new patients
Behavioral Health Consultants Psychologist Past Accepting new patients

Locations

465 N Roxbury Dr
Ste 903
Beverly Hills, CA 90210
Phone (310) 288-5933

3000 Polar Ln
Ste 101
Cedar Park, TX 78613
Phone (512) 201-4006

308 S Friendswood Dr
Ste 200
Friendswood, TX 77546
Phone (253) 346-0386

12505 Memorial Dr
Ste 230
Houston, TX 77024
Phone (210) 858-9078

3010 Scott Blvd
Ste 103
Temple, TX 76504
Phone (254) 773-4022

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": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1467583419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 POLAR LN STE 101",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786133065",
            "telephone_number": "844-824-8775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 POLAR LN STE 101",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786133065",
            "telephone_number": "844-824-8775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN STONE",
        "first_name": "KATHY",
        "middle_name": "MARIE",
        "credential": "PSY.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-08",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY19357",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "35086",
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "CA",
            "license": "PSY19357",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "35086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Park, TX

Sources for this page

Verify at the official NPI Registry.