Theresa Marie Nowak, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

128999 Issued in KY

Practice address

233 Larch LN
Lexington, KY 40511-2006

Phone

(859) 351-6471

NPI assigned

Jun 11, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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

• B 'N G Psychological Services

  • Psychologist
  • Lexington, KY
  • NPI 1861073454
  NPD Authorized official

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

{
    "created_epoch": "1591833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591833600000",
    "number": "1831714138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "233 LARCH LN",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405112006",
            "telephone_number": "859-351-6471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "233 LARCH LN",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405112006",
            "telephone_number": "859-351-6471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOWAK",
        "first_name": "THERESA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-11",
        "last_updated": "2020-06-11",
        "certification_date": "2020-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "KY",
            "license": "128999",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "KY",
            "license": "128999",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "KY",
            "license": "128999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carol Novak, CRNA
• Emily Novak, PT, DPT
• Karen Faye Novak, DDS, MS, PHD
• Michael John Novak, BDS, LDS, MS, PHD
• Margaret M Nowak-Rapp, PHARM.D.
• Kallie Bree Nowell, ATC
• Kyle Richard Nowka, TCADC
• Rachel Kathryn Nowlin
• Sahar Nozad, M.D.
• Anna Louise Nozynski

• Psychologist in Lexington, KY
• Providers in Lexington, KY by specialty
• Psychologist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2020; 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.