Organization Active NPI

Kostka Associates PLLC

  • Psychologist
  • Morgantown, WV
National Provider Identifier
1861604050
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
140 Issued in WV
Legal business name
KOSTKA ASSOCIATES PLLC
Practice address
1459 N Willey St
Morgantown, WV 26505-5236
Phone
(304) 296-4512
NPI assigned
May 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Marion P Kostka, ED.D.
Title
Owner
Phone
(304) 296-4512

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X 140 WV Primary

Addresses

Primary practice location

1459 N Willey St
Morgantown, WV 26505-5236

Mailing address

1459 N Willey St
Morgantown, WV 26505-5236
Phone (304) 296-4512

Other identifiers 1

IdentifierTypeStateIssuer
0163605000MedicaidWV

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1861604050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1459 N WILLEY ST",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265055236",
            "telephone_number": "304-296-4512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1459 N WILLEY ST",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265055236",
            "telephone_number": "304-296-4512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOSTKA ASSOCIATES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KOSTKA",
        "authorized_official_first_name": "MARION",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "304-296-4512",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "ED.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "WV",
            "license": "140",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0163605000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Morgantown, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.