Organization Active NPI

Krystal Nowak Psychology LLC

  • Clinical Psychologist
  • Midlothian, VA
National Provider Identifier
1639601461
Registry record updated Mar 30, 2017
On this page

Key facts

NPPES NPI Registry
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
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2017

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.
Title
Licensed Clinical Psychologist
Phone
(804) 719-1955

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 0810005486 VA Primary

Addresses

Primary practice location

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

Mailing address

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

National Provider Directory

National Provider Directory

NPI Registry JSON

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": []
}

Other providers in Midlothian, VA

Sources for this page

  • 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.