Individual provider Active NPI

Bethany A Koszelak, MA, CAS

  • School Psychologist
  • Alexandria, VA
National Provider Identifier
1699263715
Registry record updated Apr 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
School PsychologistTaxonomy code 103TS0200X
License
0813000834 Issued in VA
Practice address
6500 Quander Rd
Alexandria, VA 22307-1099
Phone
(703) 718-2545
NPI assigned
Apr 24, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Psychologist 103TS0200X 0813000834 VA Primary

Addresses

Primary practice location

6500 Quander Rd
Alexandria, VA 22307-1099

Mailing address

6500 Quander Rd
Alexandria, VA 22307-1099
Phone (703) 718-2545

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
0813000834VAMDSchool Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1524528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524528000000",
    "number": "1699263715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6500 QUANDER RD",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223071099",
            "telephone_number": "703-718-2545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6500 QUANDER RD",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223071099",
            "telephone_number": "703-718-2545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSZELAK",
        "first_name": "BETHANY",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "MA, CAS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-24",
        "last_updated": "2018-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "VA",
            "license": "0813000834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2018; 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.