Active NPI
Marilyn L Kistner, PHD
- Psychologist
- Danville, PA
National Provider Identifier
1679507255
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PS015365
- Practice address
- 200 State Hospital Dr
Danville, PA 17821-9198 - Phone
- (570) 271-4500
- Fax
- (570) 271-4599
- NPI assigned
- Jul 10, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PS015365 | PA | Primary |
Addresses
Primary practice location
200 State Hospital Dr
Danville, PA 17821-9198
Mailing address
200 State Hospital Dr
Danville, PA 17821-9198
Phone (570) 271-4500
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS015365 | PA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1679507255",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 STATE HOSPITAL DR",
"city": "DANVILLE",
"state": "PA",
"postal_code": "178219198",
"telephone_number": "570-271-4500",
"fax_number": "570-271-4599"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 STATE HOSPITAL DR",
"city": "DANVILLE",
"state": "PA",
"postal_code": "178219198",
"telephone_number": "570-271-4500",
"fax_number": "570-271-4599"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KISTNER",
"first_name": "MARILYN",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "PA",
"license": "PS015365",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Danville, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.