Individual provider Active NPI

Malynn Kuangparichat, PSY.D.

  • Clinical Psychologist
  • Kennett Square, PA
National Provider Identifier
1063779387
Registry record updated Apr 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS017132 Issued in PA
Practice address
500 Orchard Ave Ste C
Kennett Square, PA 19348
Phone
(484) 748-4881
NPI assigned
Apr 12, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 05484 MD
Clinical Psychologist 103TC0700X PS017132 PA Primary

Addresses

Primary practice location

500 Orchard Ave Ste C
Kennett Square, PA 19348

Mailing address

500 Orchard Ave Ste C
Kennett Square, PA 19348-1812
Phone (484) 748-4881

Other practice location 1

305 Valleybrook Rd
Chester Heights, PA 19017-0534
Phone (610) 358-2250 ext. 307

Other practice location 2

1708 W Rogers Ave
Baltimore, MD 21209-4596
Phone (410) 578-8600

Other names 1

  • Dr. Malynn Mignone Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130703000046 PA Practitioner - Clinical Psychologist 9436399078 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chester County Well-Being, LLCGroup PAC ID 6709282619, 4 clinicians

Practice addresses (Care Compare)

500 Orchard Ave
Suite C
Kennett Square, PA 19348-1812
Phone (484) 748-4881

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
05484MDMDClinical Psychologist
PS017132PAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Chester County Well-Being, LLC CurrentSince May 8, 2021 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1334188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649635200000",
    "number": "1063779387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 ORCHARD AVE STE C",
            "city": "KENNETT SQUARE",
            "state": "PA",
            "postal_code": "193481812",
            "telephone_number": "484-748-4881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 ORCHARD AVE STE C",
            "city": "KENNETT SQUARE",
            "state": "PA",
            "postal_code": "19348",
            "telephone_number": "484-748-4881"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "305 Valleybrook Rd",
            "address_purpose": "LOCATION",
            "city": "Chester Heights",
            "state": "PA",
            "postal_code": "190170534",
            "country_code": "US",
            "telephone_number": "610-358-2250 x307",
            "fax_number": "610-358-2251",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1708 W Rogers Ave",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212094596",
            "country_code": "US",
            "telephone_number": "410-578-8600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUANGPARICHAT",
        "first_name": "MALYNN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-12",
        "last_updated": "2022-04-11",
        "certification_date": "2022-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "05484",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS017132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MALYNN",
            "last_name": "MIGNONE",
            "prefix": "DR.",
            "credential": "PSY.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Kennett Square, PA

Sources for this page

Verify at the official NPI Registry.