Active NPI
Katelyn Haverstick, DPT
- Physical Therapist
- Marlton, NJ
National Provider Identifier
1467994012
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 40QA01700700
- Practice address
- 4 N Maple Ave
Marlton, NJ 08053-3008 - Phone
- (609) 410-8339
- NPI assigned
- Nov 14, 2016
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 40QA01700700 | NJ | Primary |
Addresses
Primary practice location
4 N Maple Ave
Marlton, NJ 08053-3008
Mailing address
4 N Maple Ave
Marlton, NJ 08053-3008
Phone (609) 410-8339
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40QA01700700 | NJ | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1479081600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783296000000",
"number": "1467994012",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4 N MAPLE AVE",
"city": "MARLTON",
"state": "NJ",
"postal_code": "080533008",
"telephone_number": "609-410-8339"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4 N MAPLE AVE",
"city": "MARLTON",
"state": "NJ",
"postal_code": "080533008",
"telephone_number": "609-410-8339"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAVERSTICK",
"first_name": "KATELYN",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-11-14",
"last_updated": "2026-07-06",
"certification_date": "2026-07-06",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NJ",
"license": "40QA01700700",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marlton, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.