Active NPI
Keith Happawana
- Clinical Psychologist
- Dayton, OH
National Provider Identifier
1669933719
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 180102
- Practice address
- 600 Wayne Ave
Dayton, OH 45410-1122 - Phone
- (513) 273-1140
- NPI assigned
- Mar 29, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 7296 | VA | |
| Clinical Psychologist | 103TC0700X | 180102 | AK | Primary |
| Mental Health Counselor | 101YM0800X |
Addresses
Primary practice location
600 Wayne Ave
Dayton, OH 45410-1122
Mailing address
5955 Zeamer Ave # 673MDG
Jber, AK 99506-3702
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00 | Other | MILITARY |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | Military |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 180102 | AK | MD | Clinical Psychologist |
| 7296 | VA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1553817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718582400000",
"number": "1669933719",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5955 ZEAMER AVE # 673MDG",
"city": "JBER",
"state": "AK",
"postal_code": "995063702"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 WAYNE AVE",
"city": "DAYTON",
"state": "OH",
"postal_code": "454101122",
"telephone_number": "513-273-1140"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAPPAWANA",
"first_name": "KEITH",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-03-29",
"last_updated": "2024-06-17",
"certification_date": "2024-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "VA",
"license": "7296",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "AK",
"license": "180102",
"primary": true
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MILITARY",
"identifier": "00",
"state": null
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "Military",
"affiliation": "N",
"endpointDescription": "Military",
"address_1": "4881 Sugar Maple Dr",
"city": "Dayton",
"state": "OH",
"country_code": "US",
"postal_code": "454335529",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Dayton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.