Individual provider Active NPI

Kate Junk, PH.D.

  • Counseling Psychologist
  • Johnston, IA
National Provider Identifier
1801204037
Registry record updated Apr 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
001295 Issued in IA
Practice address
9105 Northpark Dr
Johnston, IA 50131-4807
Phone
(515) 984-0225
Fax
(515) 984-0226
NPI assigned
Jul 31, 2014
Last updated
Apr 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X 000623 IA
Counseling Psychologist 103TC1900X 001295 IA Primary

Addresses

Primary practice location

9105 Northpark Dr
Johnston, IA 50131-4807

Mailing address

9105 Northpark Dr
Johnston, IA 50131-4807
Phone (515) 984-0225

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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

Enrollment IDStateProvider typePAC IDDetails
I20140814001385 IA Practitioner - Clinical Psychologist 7214154251 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Willow Grove Therapy Group LLCGroup PAC ID 9931464468, 3 clinicians

Practice addresses (Care Compare)

9105 Northpark Dr
Johnston, IA 50131-4807
Phone (515) 984-0225

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
000623IAMDCounseling Psychologist
001295IAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Willow Grove Therapy Group LLC Counseling CurrentSince Jul 1, 2018 Accepting new patients
Julie McClatchey, Lisw, PC PastSince Apr 28, 2024 Accepting new patients

Locations

9105 Northpark Dr
Johnston, IA 50131
Phone (515) 884-8802

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1406764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714089600000",
    "number": "1801204037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9105 NORTHPARK DR",
            "city": "JOHNSTON",
            "state": "IA",
            "postal_code": "501314807",
            "telephone_number": "515-984-0225",
            "fax_number": "515-984-0226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9105 NORTHPARK DR",
            "city": "JOHNSTON",
            "state": "IA",
            "postal_code": "501314807",
            "telephone_number": "515-984-0225",
            "fax_number": "515-984-0226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUNK",
        "first_name": "KATE",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-31",
        "last_updated": "2024-04-26",
        "certification_date": "2024-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "IA",
            "license": "000623",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "IA",
            "license": "001295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnston, IA

Sources for this page

Verify at the official NPI Registry.