Active NPI
Kathleen A. Mack, PSY.D.
- Clinical Psychologist
- Cincinnati, OH
National Provider Identifier
1982679403
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 3898
- Practice address
- 8 Triangle Park Dr
Suite 804
Cincinnati, OH 45246-3404 - Phone
- (513) 771-8555
- Fax
- (513) 771-8556
- NPI assigned
- Feb 19, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 3898 | OH | Primary |
| Health Service Psychologist | 103TH0100X | 3898 | OH | |
| Psychologist | 103T00000X | 3898 | OH |
Addresses
Primary practice location
8 Triangle Park Dr
Suite 804
Cincinnati, OH 45246-3404
Mailing address
PO Box 674
Loveland, OH 45140-0674
Phone (513) 771-8555
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140307200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1344816000000",
"number": "1982679403",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 674",
"city": "LOVELAND",
"state": "OH",
"postal_code": "451400674",
"telephone_number": "513-771-8555",
"fax_number": "513-771-8556"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8 TRIANGLE PARK DR",
"address_2": "SUITE 804",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452463404",
"telephone_number": "513-771-8555",
"fax_number": "513-771-8556"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACK",
"first_name": "KATHLEEN",
"middle_name": "A.",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-02-19",
"last_updated": "2012-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "OH",
"license": "3898",
"primary": true
},
{
"code": "103TH0100X",
"taxonomy_group": "",
"desc": "Psychologist, Health Service",
"state": "OH",
"license": "3898",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "OH",
"license": "3898",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cincinnati, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.