MR. KEVIN WILFONG (NPI# 1750996054) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750996054 |
| Entity Type | Individual |
| Full Name | MR. KEVIN WILFONG |
| Practice Address |
620 John Paul Jones Cir Portsmouth VA 23708-2111 |
| Mailing Address |
2212 Humphreys Dr Suffolk VA 23435-3455 |
| Practice Telephone | 2816156193 |
| Enumeration Date | 2020-09-14 |
| Last Update Date | 2020-09-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | Behavioral Health & Social Service Providers |
| Street Address |
620 JOHN PAUL JONES CIR |
| City | PORTSMOUTH |
| State | VA |
| Zip Code | 23708-2111 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427054840 | Debra Tooke Crowell | Registered Nurse | 620 John Paul Jones Cir, Portsmouth, VA 23708-2111 | 2005-06-21 |
| 1659970424 | Jennifer T Birchwale | Student in an Organized Health Care Education/Training Program | 620 John Paul Jones Cir, Portsmouth, VA 23708-2111 | 2020-10-22 |
| 1861091985 | Carin Kimberly Teeters | Psychologist | 620 John Paul Jones Cir, Portsmouth, VA 23708-2111 | 2020-10-20 |
| 1275130825 | Dartangion Pierre Walker | Dental Hygienist | 620 John Paul Jones Cir, Portsmouth, VA 23708-2111 | 2020-10-07 |
| 1598379901 | Paula Shepard | Psychologist | 620 John Paul Jones Cir, Portsmouth, VA 23708-2111 | 2020-09-02 |
| 1578177234 | Rebekah Gunter | Psychologist | 620 John Paul Jones Cir, Portsmouth, VA 23708-2111 | 2020-09-01 |
| 1225641863 | Dylan Quoc-chuong Vu | Dentist | 620 John Paul Jones Cir, Portsmouth, VA 23708-2111 | 2020-08-24 |
| 1467060111 | Ili Yuan | Dentist | 620 John Paul Jones Cir, Portsmouth, VA 23708-2111 | 2020-07-20 |
| 1750909172 | Marsades Ceasar | Social Worker | 620 John Paul Jones Cir, Portsmouth, VA 23708-2111 | 2020-07-13 |
| 1356969067 | Traci Joy Mckinnon | Nurse Practitioner | 620 John Paul Jones Cir, Portsmouth, VA 23708-2111 | 2020-07-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932724754 | William Dowling | Student in an Organized Health Care Education/Training Program | 260 John Paul Jones Circle, Fpo, AA 23708 | 2020-06-09 |
| 1760003156 | Kylie Miller | Student in an Organized Health Care Education/Training Program | 600 John Paul Jones Circle, Portsmouth, VA 23708 | 2020-04-27 |
| 1750900304 | Jonathan David Hickman | Student in an Organized Health Care Education/Training Program | Nmcp 620 John Paul Jones Cir., Bldg 3, Portsmouth, VA 23708 | 2020-04-14 |
| 1447716550 | Nathan Le Holterman | Student in an Organized Health Care Education/Training Program | Navy Medical Center Portsmouth, 620 John Paul Jones Circle, Portsmouth, VA 23708 | 2019-02-13 |
| 1467930545 | Jonathan Volland | Dentist | Naval Medical Center - 620 John Paul Jones Cr, Portsmouth, VA 23708 | 2018-08-01 |
| 1629570171 | Brendan James O'shea | Student in an Organized Health Care Education/Training Program | 690 John Paul Jones Circle, Fpo, AA 23708 | 2018-03-01 |
| 1467909077 | Patricia Hicks Smith | Nurse Practitioner | 620 John Paul Jones Blvd., Naval Medical Center Portsmouth, Portsmouth, VA 23708 | 2016-09-01 |
| 1790139392 | Lauren Pitters | Student in an Organized Health Care Education/Training Program | 620 John Paul Jones Circle Drive, Naval Medical Center Portsmouth, Portsmouth, VA 23708 | 2016-04-20 |
| 1841683745 | Karrie Anne Brondell Walker | Student in an Organized Health Care Education/Training Program | 620 John Paul Jones, Naval Medical Center Portsmouth, Portsmouth, VA 23708 | 2015-03-17 |
| 1962821967 | Jody Manners | Psychiatry & Neurology | 620 John Paul Jones Cir # 2e, Portsmouth, VA 23708 | 2014-04-08 |
| Find all providers in zip 23708 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306329248 | Stephen Gerard Virginia | Psychologist | 1020 27th St, Portsmouth, OH 45662-2513 | 2018-09-06 |
| 1558812743 | Danielle Gissinger | Psychologist | 147 Congress St Ste D4, Portsmouth, NH 03801-6614 | 2016-10-22 |
| 1487051116 | Carolyn Kyne | Psychologist | 5668 State Route 139, Portsmouth, OH 45662-8626 | 2014-11-24 |
| 1063716793 | Amber Kaltenstein | Psychologist | 2820 E Main Rd, Portsmouth, RI 02871 | 2011-01-10 |
| 1942342415 | Sandra Kathryn Yarne | Psychologist | 20 Ladd Street, Suite 405, Portsmouth, NH 03801-4080 | 2007-02-13 |
| 1740321124 | R Brad Lebo | Psychologist | 404 The Hill, Portsmouth, NH 03801-3736 | 2007-02-09 |
| 1255470696 | Bruce Altman | Psychologist | 500 Market St Unit 1g, Portsmouth, NH 03801-3456 | 2007-02-05 |
| 1316016983 | John Stephen Clifford | Psychologist | 8 Kirduglyn Rd, Portsmouth, RI 02871-3916 | 2006-11-07 |
| 1710080361 | James A Azar | Psychologist | 2679 East Main Rd, Portsmouth, RI 02871 | 2006-09-07 |
| 1457363442 | Allan M Lurvey | Psychologist | 3 Greenleaf Woods Dr Unit 101, Portsmouth, NH 03801-5440 | 2006-08-12 |
| Find all providers in PORTSMOUTH | ||||
| City | PORTSMOUTH |
| Zip Code | 23708 |
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| 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.