Individual provider Active NPI

Krysta Webster Fink, PH.D.

  • Clinical Psychologist
  • Florence, SC
National Provider Identifier
1497902472
Registry record updated Jun 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1375 Issued in SC
Practice address
1801 W Evans St Ste D105
Florence, SC 29501-3376
Phone
(843) 920-6953
NPI assigned
Aug 21, 2008
Last updated
Jun 3, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 0810004664 VA
Clinical Psychologist 103TC0700X 1375 SC Primary

Addresses

Primary practice location

1801 W Evans St Ste D105
Florence, SC 29501-3376

Mailing address

1801 W Evans St Ste D105
Florence, SC 29501-3376
Phone (843) 920-6953

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180627000365 VA Practitioner - Psychologist Billing Independently 7315293701 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2011
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

201 Church St SE
Suite D
Blacksburg, VA 24060-4878
Phone (843) 632-0345

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Krysta Webster Fink, PH.D. Clinical CurrentSince Nov 16, 2020 Accepting new patients
The Cascade Group Inc PastSince Oct 1, 2021 Accepting new patients
Suzanne R Eaton Psy.D. PLLC Clinical Past Accepting new patients
Blacksburg Behavioral Health, LLC Clinical Past Accepting new patients

Locations

201 Church St SE
Ste D
Blacksburg, VA 24060
Phone (540) 200-8399

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1219276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717372800000",
    "number": "1497902472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 W EVANS ST STE D105",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295013376",
            "telephone_number": "843-920-6953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 W EVANS ST STE D105",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295013376",
            "telephone_number": "843-920-6953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FINK",
        "first_name": "KRYSTA",
        "middle_name": "WEBSTER",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-21",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810004664",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "SC",
            "license": "1375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.