Individual provider Active NPI

Victoria Stewart, PSY.D.

  • Clinical Psychologist
  • Clarks Summit, PA
National Provider Identifier
1598060493
Registry record updated Jan 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS016948 Issued in PA
Practice address
400 S State St
Clarks Summit, PA 18411-1589
Phone
(570) 815-5090
NPI assigned
Jan 24, 2011
Last updated
Jan 24, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PS016948 PA Primary

Addresses

Primary practice location

400 S State St
Clarks Summit, PA 18411-1589

Mailing address

400 S State St
Clarks Summit, PA 18411-1589
Phone (570) 815-5090

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20110923000192 PA Practitioner - Clinical Psychologist 6608047691 Reassigns benefits to 1 organization
Practice locations: Clarks Summit, PA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

395 Bedford St
Suite C
Clarks Summit, PA 18411-1805
Phone (570) 815-5090

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Stewart Psychological & Consultation Services, LLC CurrentSince Nov 17, 2018 Accepting new patients

Locations

395 Bedford St
Ste C
Clarks Summit, PA 18411
Phone (570) 815-5090

Organizations & group practices 1

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": "1295827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295827200000",
    "number": "1598060493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 S STATE ST",
            "city": "CLARKS SUMMIT",
            "state": "PA",
            "postal_code": "184111589",
            "telephone_number": "570-815-5090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S STATE ST",
            "city": "CLARKS SUMMIT",
            "state": "PA",
            "postal_code": "184111589",
            "telephone_number": "570-815-5090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "VICTORIA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-01-24",
        "last_updated": "2011-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS016948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarks Summit, PA

Sources for this page

Verify at the official NPI Registry.