Individual provider Active NPI

Angela Klingensmith, PSYD

  • Psychologist
  • Richland, WA
National Provider Identifier
1962926485
Registry record updated Jan 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
AP60098621 Issued in WA
Practice address
719 Jadwin Ave
Richland, WA 99352-4217
Phone
(509) 214-1894
Fax
(509) 464-6597
NPI assigned
Jul 26, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 3182 OR
Clinical Psychologist 103TC0700X 3182 OR
Psychologist 103T00000X AP60098621 WA Primary

Addresses

Primary practice location

719 Jadwin Ave
Richland, WA 99352-4217

Mailing address

719 Jadwin Ave
Richland, WA 99352-4217
Phone (509) 214-1894

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
I20210304002558 WA Practitioner - Clinical Psychologist 3072933654 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

719 Jadwin Ave
Richland, WA 99352-4217
Phone (715) 330-1183

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3182ORMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Klingensmith Counseling and Psychological Services Clinical CurrentSince Mar 1, 2024 Accepting new patients

Locations

719 Jadwin Ave
Ste 71911
Richland, WA 99352
Phone (715) 330-1183

Organizations & group practices 1

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": "1501027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705622400000",
    "number": "1962926485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "719 JADWIN AVE",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993524217",
            "telephone_number": "509-214-1894",
            "fax_number": "509-464-6597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "719 JADWIN AVE",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993524217",
            "telephone_number": "509-214-1894",
            "fax_number": "509-464-6597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLINGENSMITH",
        "first_name": "ANGELA",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-26",
        "last_updated": "2024-01-19",
        "certification_date": "2024-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OR",
            "license": "3182",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "3182",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WA",
            "license": "AP60098621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richland, WA

Sources for this page

Verify at the official NPI Registry.