Kim Havenner, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0810004884 Issued in VA

Practice address

10805 Main St Ste 500
Fairfax, VA 22030-4747

Phone

(703) 283-4153

NPI assigned

Nov 21, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

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": "1384992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384992000000",
    "number": "1972933364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10714 SCOTT DR",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220303023",
            "telephone_number": "703-283-4153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10805 MAIN ST STE 500",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220304747",
            "telephone_number": "703-283-4153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAVENNER",
        "first_name": "KIM",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-21",
        "last_updated": "2013-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810004884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Albert Hattwick, MD
• Alanah Lavern Haugabrook
• Katelyn Currin Haughinberry, NP
• Sheila Hautbois, PA-C
• Haven J. Barlow, Jr., MD, PC
• Carol A. Hawker, L.P.C.
• Brittani Hawkins, LCSW-C
• Jaquese Simone Hawkins
• Leslie Ann Hawkins, PSY.D
• Melody Noles Hawkins, M.D.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2013; 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.