Individual provider Active NPI

Constance A Kehrer, PH.D.

  • Clinical Psychologist
  • Bellevue, WA
National Provider Identifier
1851330716
Registry record updated Mar 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY2551 Issued in WA
Practice address
1601 114TH Ave SE
Suite 145
Bellevue, WA 98004-6950
Phone
(425) 454-3110
Fax
(425) 283-0486
NPI assigned
Jun 6, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY2551 WA Primary

Addresses

Primary practice location

1601 114TH Ave SE
Suite 145
Bellevue, WA 98004-6950

Mailing address

1601 114TH Ave SE
Suite 145
Bellevue, WA 98004-6950
Phone (425) 454-3110

Other identifiers 2

IdentifierTypeStateIssuer
PY00002551OtherWAPROFESSIONAL LICENSE
0203722OtherWALABOR AND INDUSTRIES ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20060131000130 WA Practitioner - Clinical Psychologist 8527072412 Practice locations: Bellevue, WA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1621 114TH Ave SE
Suite 221
Bellevue, WA 98004-6905
Phone (425) 301-8832

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PY2551WAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Beth Wilson, PHD PastSince Jul 24, 2022 Accepting new patients
Eastside Behavioral Medicine Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236124800000",
    "number": "1851330716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 114TH AVE SE",
            "address_2": "SUITE 145",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980046950",
            "telephone_number": "425-454-3110",
            "fax_number": "425-283-0486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 114TH AVE SE",
            "address_2": "SUITE 145",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980046950",
            "telephone_number": "425-454-3110",
            "fax_number": "425-283-0486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEHRER",
        "first_name": "CONSTANCE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-06",
        "last_updated": "2009-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY2551",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROFESSIONAL LICENSE",
            "identifier": "PY00002551",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES ID",
            "identifier": "0203722",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

Verify at the official NPI Registry.