KRYSTAL NOWAK PSYCHOLOGY LLC (NPI# 1639601461) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639601461 |
| Entity Type | Organization |
| Organization Name | KRYSTAL NOWAK PSYCHOLOGY LLC |
| Practice Address |
4920 Millridge Pkwy E Suite 206 Midlothian VA 23112-4857 |
| Practice Telephone | 8047191955 |
| Enumeration Date | 2017-03-30 |
| Last Update Date | 2017-03-30 |
| Authorized Official Name | DR. KRYSTAL STUDIVANT NOWAK (LICENSED CLINICAL PSYCHOLOGIST) |
| Authorized Official Telephone | 8047191955 |
| Authorized Official Credential | PSY.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
0810005486 | VA | Behavioral Health & Social Service Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | Krystal Nowak Psychology LLC | 1 Park West Circle, Suite 306n, Midlothian, Virginia 23114 |
| Street Address |
4920 MILLRIDGE PKWY E SUITE 206 |
| City | MIDLOTHIAN |
| State | VA |
| Zip Code | 23112-4857 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811916588 | Frank Edward Crow | Counselor | 4920 Millridge Pkwy E, Suite 206, Midlothian, VA 23112-4857 | 2006-07-19 |
| 1760803399 | Christine Komiske Dwyer, Lcsw, LLC | Social Worker | 4920 Millridge Pkwy E, Suite 206, Midlothian, VA 23112-4857 | 2013-12-28 |
| 1366874851 | Marchelle Leialoha II | Massage Therapist | 4920 Millridge Pkwy E, Suite 206, Midlothian, VA 23112-4857 | 2013-08-06 |
| 1972749562 | Phyllis J. Jones | Counselor | 4920 Millridge Pkwy E, Ste 206, Midlothian, VA 23112-4857 | 2009-01-02 |
| 1760405880 | Nicholas Grillo Jr. | Social Worker | 4920 Millridge Pkwy E, Suite 212, Midlothian, VA 23112-4857 | 2006-07-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982170080 | Shonmarra Ylexus Glover | Behavior Technician | 5950 Harbour Lane, Midlothian, VA 23112 | 2018-10-17 |
| 1841778917 | Brett Stires | Behavior Technician | 5950 Harbourt Park Dr, Midlothian, VA 23112 | 2018-08-01 |
| 1538655899 | Surbhi Chandna | Dentist | 5921 Harbour Ln Ste 500, Midlothian, VA 23112 | 2018-07-10 |
| 1184121584 | Katie Marie Kashmer | Behavioral Analyst | 5950 Barbour Park Lane, Midlothian, WA 23112 | 2018-04-11 |
| 1497259832 | Ruth Lynn Kitchens | Occupational Therapist | 13900 Hull Street Rd., Midlothian, VA 23112 | 2018-03-21 |
| 1487157301 | Susan Stoodt Price | Occupational Therapist | Chesterfield Technical Center Hull, 13900 Hull Street Rd., Midlothian, VA 23112 | 2018-03-16 |
| 1922500495 | Rayna Veney Piper | Speech-Language Pathologist | 13900 Hull Street Road, Midlothian, VA 23112 | 2018-03-01 |
| 1891202883 | Rochelle Wallace | Behavioral Analyst | 5950 Harbourt Park Dr., Midlothian, VA 23112 | 2017-12-29 |
| 1184138448 | Virginia Medical & Therapeutic Services | Counselor | 13540 E Boundary Rd, Midlothian, VA 23112 | 2017-11-24 |
| 1386169118 | Brandon Poen | Physical Therapist | 2820 Waterford Lake Dr., Unit 013, Midlothian, VA 23112 | 2017-08-14 |
| Find all providers in zip 23112 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699385013 | Celeste Macdonald Kelly | Psychologist | 250 Wylderose Cmns, Midlothian, VA 23113-6883 | 2020-08-01 |
| 1447736806 | Kaitlin Elizabeth Bountress | Psychologist | 15521 Midlothian Tpke Ste 105, Midlothian, VA 23113-7313 | 2018-07-18 |
| 1801215066 | Krystal Studivant Nowak | Psychologist | 1 Park West Cir Ste 306n, Midlothian, VA 23114-5552 | 2014-04-15 |
| 1245675958 | Ashley Marie Foresman | Psychologist | 13901 Coalfield Commons Pl Ste 102, Midlothian, VA 23114-1216 | 2013-05-08 |
| 1952603409 | Lindsey Kate Slaughter | Psychologist | 13321 Diamond Ridge Dr, Midlothian, VA 23112-8340 | 2010-12-03 |
| 1831407824 | Lee Saecker Ridens | Psychologist | 13821 Village Mill Dr Ste B, Midlothian, VA 23114-4314 | 2010-09-23 |
| 1316177041 | James R Moon | Psychologist | 12807 Rossmere Ct, Midlothian, VA 23114-3093 | 2009-07-15 |
| 1821241365 | Andrew Charles Cox | Psychologist | 13354 Midlothian Tpke Ste 200, Midlothian, VA 23113-4258 | 2008-10-28 |
| 1174771737 | Melinda Beth Moore | Psychologist | 15521 Midlothian Turnpike, Suite 105, Midlothian, VA 23114 | 2008-09-08 |
| 1689861247 | Mary Hill Bradshaw | Psychologist | 5715 Saddle Hill Dr, Midlothian, VA 23112-2383 | 2007-09-27 |
| Find all providers in MIDLOTHIAN | ||||
| City | MIDLOTHIAN |
| Zip Code | 23112 |
Please comment or provide details below to improve the information on KRYSTAL NOWAK PSYCHOLOGY LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.