Active NPI
Stephanie Kaye Nowacki-Butzen, PSY.D.
- Clinical Psychologist
- Charlottesville, VA
National Provider Identifier
1831493253
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 0810004327
- Practice address
- 911 E Jefferson St
Charlottesville, VA 22902-5355 - Phone
- (434) 984-0023
- NPI assigned
- Dec 28, 2010
- Sex
- Female
- Sole proprietor
- No
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 | 0810004327 | VA | Primary |
Addresses
Primary practice location
911 E Jefferson St
Charlottesville, VA 22902-5355
Mailing address
911 E Jefferson St
Charlottesville, VA 22902-5355
Phone (434) 984-0023
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0810004327 | VA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1293494400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1293494400000",
"number": "1831493253",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "911 E JEFFERSON ST",
"city": "CHARLOTTESVILLE",
"state": "VA",
"postal_code": "229025355",
"telephone_number": "434-984-0023"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "911 E JEFFERSON ST",
"city": "CHARLOTTESVILLE",
"state": "VA",
"postal_code": "229025355",
"telephone_number": "434-984-0023"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NOWACKI-BUTZEN",
"first_name": "STEPHANIE",
"middle_name": "KAYE",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-12-28",
"last_updated": "2010-12-28",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "VA",
"license": "0810004327",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlottesville, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.