Organization Active NPI

Kosmos Psychology

  • Psychologist
  • Salem, OR
National Provider Identifier
1073331252
Registry record updated Sep 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
KOSMOS PSYCHOLOGY
Practice address
2355 State St Ste 101
Salem, OR 97301-4541
Phone
(503) 714-1144
NPI assigned
Sep 27, 2024
Last updated
Sep 27, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2024

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

Authorized official

Name
Dr. Kat Prince Kosmos, PSYD
Title
Owner
Phone
(503) 714-1144

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X NU
Psychologist 103T00000X NU Primary
Cognitive & Behavioral Psychologist 103TB0200X NU
Clinical Psychologist 103TC0700X NU
Counseling Psychologist 103TC1900X NU
Intellectual & Developmental Disabilities Psychologist 103TM1800X NU

Addresses

Primary practice location

2355 State St Ste 101
Salem, OR 97301-4541

Mailing address

2355 State St Ste 101
Salem, OR 97301-4541

Other identifiers 1

IdentifierTypeStateIssuer
1629567599MedicaidOR

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1727395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727395200000",
    "number": "1073331252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2355 STATE ST STE 101",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973014541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2355 STATE ST STE 101",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973014541",
            "telephone_number": "503-714-1144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOSMOS PSYCHOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-27",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A",
        "authorized_official_last_name": "PRINCE KOSMOS",
        "authorized_official_first_name": "KAT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-714-1144",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1629567599",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 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.