Kevin Haworth, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

3748-57 Issued in WI

Practice address

250 N Sunny Slope Rd Ste 203
Brookfield, WI 53005-4824

Phone

(262) 782-2820

NPI assigned

Jan 22, 2020

Last updated

Jan 28, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

University of Wisconsin School of Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Center for Behavioral Medicine SCGroup PAC ID 2567488323, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Center for Behavioral Medicine, SC

  • Clinical Psychologist
  • Brookfield, WI
  • NPI 1578515417
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1579651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580169600000",
    "number": "1740810415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2519 CROASDAILE FARM PKWY APT 10",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277052266",
            "telephone_number": "206-321-5331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 N SUNNY SLOPE RD STE 203",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530054824",
            "telephone_number": "262-782-2820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAWORTH",
        "first_name": "KEVIN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-01-22",
        "last_updated": "2020-01-28",
        "certification_date": "2020-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "3748-57",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan Neil Hatchell, MD
• Shelby Hausman, LPC
• Kevin J Havelka, RPH
• Howard Joel Haven, PHD
• Kelly Ann Hawkins, APSW
• Nancy R. Haworth, M.D.
• Rylie Hayes
• Theresa K Hayssen, MD
• Healing Corner, LLC
• Healing Hearts Wellness LLC

• Psychologist in Brookfield, WI
• Providers in Brookfield, WI by specialty
• Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.