Krystal Nowak Psychology LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0810005486 Issued in VA

Legal business name

KRYSTAL NOWAK PSYCHOLOGY LLC

Practice address

4920 Millridge Pkwy E
Suite 206
Midlothian, VA 23112-4857

Phone

(804) 719-1955

NPI assigned

Mar 30, 2017

Last updated

Mar 30, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Krystal Studivant Nowak, PSY.D.NPI 1801215066

Title

Licensed Clinical Psychologist

Phone

(804) 719-1955

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Krystal Studivant Nowak, PSY.D.

  • Clinical Psychologist
  • Midlothian, VA
  • NPI 1801215066
  Authorized official Same address or phone

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

{
    "created_epoch": "1490832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490832000000",
    "number": "1639601461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4920 MILLRIDGE PKWY E",
            "address_2": "SUITE 206",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231124857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4920 MILLRIDGE PKWY E",
            "address_2": "SUITE 206",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231124857",
            "telephone_number": "804-719-1955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KRYSTAL NOWAK PSYCHOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-30",
        "last_updated": "2017-03-30",
        "status": "A",
        "authorized_official_last_name": "NOWAK",
        "authorized_official_first_name": "KRYSTAL",
        "authorized_official_middle_name": "STUDIVANT",
        "authorized_official_title_or_position": "LICENSED CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "804-719-1955",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810005486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kroger Limited Partnership I (Kroger Pharmacy)
• Kroger Limited Partnership I (Kroger Pharmacy)
• Michael Eugene Krone, D.D.S.
• Zachary Krpejs
• Christopher Daniel Kruse, PT
• Robert Richard Krzyzanowski, PHARMD
• Kris Kuester
• Amanda Kuhn, D.M.D.
• Ramesh Narasimhaiah Kundur, M.D.
• Helen L. Kuno, MD

• Clinical Psychologist in Midlothian, VA
• Providers in Midlothian, VA by specialty
• Clinical Psychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.