Cathleen A. Rea, PH.D.

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

0810-001325 Issued in VA

Practice address

12695 McManus Blvd
BLDG #8
Newport News, VA 23602-4435

Phone

(757) 877-7700

Fax

(757) 872-7211

NPI assigned

Oct 20, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 1, 2019 through Jan 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811070360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12695 MCMANUS BLVD",
            "address_2": "BLDG #8",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236024435",
            "telephone_number": "757-877-7700",
            "fax_number": "757-872-7211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12695 MCMANUS BLVD",
            "address_2": "BLDG #8",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236024435",
            "telephone_number": "757-877-7700",
            "fax_number": "757-872-7211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REA",
        "first_name": "CATHLEEN",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "VA",
            "license": "0810-001325",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77-0279-5",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Child & Adolescent Psychologist in Newport News, VA
• Providers in Newport News, VA by specialty
• Clinical Child & Adolescent Psychologist in Virginia

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.