Kristin Willert, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

06355 Issued in MD

Practice address

44075 Pipeline PLZ Ste 300
Ashburn, VA 20147-5889

Phone

(815) 793-3787

NPI assigned

May 27, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1590537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595808000000",
    "number": "1912520842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14044 CHESTNUT CT",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207075873",
            "telephone_number": "651-808-8688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44075 PIPELINE PLZ STE 300",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201475889",
            "telephone_number": "815-793-3787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLERT",
        "first_name": "KRISTIN",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-27",
        "last_updated": "2020-07-27",
        "certification_date": "2020-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "36042",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "06355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Whole Child Pediatrics
• Hetti Thantrige Hiruni Wathsala Wickramasinghe, M.D.
• John C Wiger, DDS MS
• Brett Michael Wigley, BCBA
• Jennifer S Wilder, MD
• Amanda Joslin Williams, PH.D.
• Benjamin D. Williams, PH.D.
• Brittany La'Trell Williams
• Charlie Vee Williams, LPC
• Emily Ruth Williams, DO

• Clinical Psychologist in Ashburn, VA
• Providers in Ashburn, VA by specialty
• Clinical Psychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 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.