Ibrahim Kurdieh, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY 60523286 Issued in WA

Practice address

945 11TH Ave
Suite B
Longview, WA 98632-2555

Phone

(360) 414-8600

Fax

(360) 636-7372

NPI assigned

Dec 4, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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.

• Dr. Ibrahim Kurdieh, Psychologist, Inc

  • Psychologist
  • Pittsburgh, PA
  • NPI 1164254082
  NPD Authorized official
• Neurothryve

  • Clinical Psychologist
  • Vancouver, WA
  • NPI 1851835920
  NPD (past)

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

{
    "created_epoch": "1417651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467936000000",
    "number": "1063819175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2621 NE 134TH ST",
            "address_2": "STE 340",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986863036",
            "telephone_number": "360-450-0140",
            "fax_number": "877-343-0535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "945 11TH AVE",
            "address_2": "SUITE B",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986322555",
            "telephone_number": "360-414-8600",
            "fax_number": "360-636-7372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KURDIEH",
        "first_name": "IBRAHIM",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-12-04",
        "last_updated": "2016-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY 60523286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vishal Kumar, MD
• Peter Kung, M.D.
• Nichole Kayleen Kunkle
• Pema Kunsang, BSN
• Kevin Kuper, BA, R-AAC
• Pamela Elin Kurthy, LICSW ACSW
• Machelle Denise Kurtz I, CP 61083985
• Laboratory Corpoation of America
• Brandon Laborico, BA
• Denny Michael Lafountaine, LMT

• Clinical Psychologist in Longview, WA
• Providers in Longview, WA by specialty
• Clinical Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2016; 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.