Rebecca Smolak-Kettlehake Psy D LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

B1-0000893 Issued in DE

Legal business name

REBECCA SMOLAK-KETTLEHAKE PSY D LLC

Practice address

200 Biddle Ave
Suite 105
Newark, DE 19702-3968

Phone

(302) 261-6901

Fax

(302) 365-6072

NPI assigned

May 27, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Rebecca Ann Smolak-Kettlehake, PSY.D.NPI 1255603593

Title

Psychologist

Phone

(302) 261-6901

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DE

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Rebecca Ann Smolak-Kettlehake, PSY.D.

  • Psychologist
  • Newark, DE
  • NPI 1255603593
  Medicare reassignment NPD Authorized official
• Teri Lyn Smith, MSW/LCSW

  • Clinical Social Worker
  • Newark, DE
  • NPI 1568635381
  NPD (past)

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

{
    "created_epoch": "1432684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432684800000",
    "number": "1497134100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 BIDDLE AVE",
            "address_2": "SUITE 105",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197023968",
            "telephone_number": "302-261-6901",
            "fax_number": "302-365-6072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 BIDDLE AVE",
            "address_2": "SUITE 105",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197023968",
            "telephone_number": "302-261-6901",
            "fax_number": "302-365-6072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REBECCA SMOLAK-KETTLEHAKE PSY D LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-27",
        "last_updated": "2015-05-27",
        "status": "A",
        "authorized_official_last_name": "SMOLAK-KETTLEHAKE",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "302-261-6901",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "DE",
            "license": "B1-0000893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Reid A Ravin, M.D.
• Joshua Ben Ray
• Maria Frangia Rayias, PHD
• Francia Raymond
• Gavin Reazor
• William J. Recktenwald, D.M.D.
• John William Records, PT
• Recovery Centers of America Outpatient Services de LLC
• Recovery Innovations, Inc
• Ashwin N Reddi, MD

• Clinical Psychologist in Newark, DE
• Providers in Newark, DE by specialty
• Clinical Psychologist in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2015; 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.