Sandra E. Klos, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PS004348L Issued in PA

Practice address

63 Chestnut Rd Ste 1
Paoli, PA 19301-1535

Phone

(610) 667-9774

NPI assigned

Oct 15, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• The Anxiety & Behavior Change Program for Children

  • Clinical Psychologist
  • Bala Cynwyd, PA
  • NPI 1770661159
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1192406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728000000000",
    "number": "1063601193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2221 ELLSWORTH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191462811",
            "telephone_number": "215-280-7449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 CHESTNUT RD STE 1",
            "city": "PAOLI",
            "state": "PA",
            "postal_code": "193011535",
            "telephone_number": "610-667-9774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLOS",
        "first_name": "SANDRA",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-15",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PA",
            "license": "PS004348L",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS004348L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda Kiefer, LCSW
• G. Edward Kienzle, MD
• Rand E Kienzle, MD
• Michelle Kimmerly
• Abigail Zisk Kindler, PHD
• Cynthia Knapp, MA
• Haeng Ko, MD
• James J Ko, MD
• Caitlan Lisa Pyden Koah, PA-C, MS
• Martha Kob

• Clinical Psychologist in Paoli, PA
• Providers in Paoli, PA by specialty
• Clinical Psychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2024; 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.