Active NPI
Kathleen A Vilardi, PHD
- Clinical Psychologist
- Fair Haven, NJ
National Provider Identifier
1679757447
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 35SI00319600
- Practice address
- 68 Forman St
Fair Haven, NJ 07704 - Phone
- (732) 804-0893
- NPI assigned
- Dec 28, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 35SI00319600 | NJ | Primary |
Addresses
Primary practice location
68 Forman St
Fair Haven, NJ 07704
Mailing address
31 De Normandie Ave
Fair Haven, NJ 07704
Phone (732) 804-0893
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 |
|---|---|---|---|
| 35SI00319600 | NJ | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1198800000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1198800000000",
"number": "1679757447",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "31 DE NORMANDIE AVE",
"city": "FAIR HAVEN",
"state": "NJ",
"postal_code": "07704",
"telephone_number": "732-804-0893"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "68 FORMAN ST",
"city": "FAIR HAVEN",
"state": "NJ",
"postal_code": "07704",
"telephone_number": "732-804-0893"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VILARDI",
"first_name": "KATHLEEN",
"middle_name": "A",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-12-28",
"last_updated": "2007-12-28",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NJ",
"license": "35SI00319600",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fair Haven, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 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.