Individual provider Active NPI

Kylie Rodenhaber, PSY.D.

  • Psychologist
  • Southampton, PA
National Provider Identifier
1093680662
Registry record updated Oct 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PS020601 Issued in PA
Practice address
928 Jaymor Rd Ste B-150
Southampton, PA 18966-3853
Phone
(215) 947-8654
NPI assigned
Oct 6, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PS020601 PA Primary

Addresses

Primary practice location

928 Jaymor Rd Ste B-150
Southampton, PA 18966-3853

Mailing address

928 Jaymor Rd Ste B-150
Southampton, PA 18966-3853

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
I20251024002107 PA Practitioner - Clinical Psychologist 2264920776 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Growth Opportunity CenterGroup PAC ID 9335051085, 27 clinicians

Practice addresses (Care Compare)

928 Jaymor Rd
Suite B 150
Southampton, PA 18966-3853
Phone (215) 947-8654

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PS020601PAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Growth Opportunity Center CurrentSince Oct 10, 2025 Accepting new patients

Locations

928 Jaymor Rd
Ste B150
Southampton, PA 18966
Phone (215) 947-8654

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": "1759708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759708800000",
    "number": "1093680662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "928 JAYMOR RD STE B-150",
            "city": "SOUTHAMPTON",
            "state": "PA",
            "postal_code": "189663853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "928 JAYMOR RD STE B-150",
            "city": "SOUTHAMPTON",
            "state": "PA",
            "postal_code": "189663853",
            "telephone_number": "215-947-8654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODENHABER",
        "first_name": "KYLIE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-06",
        "last_updated": "2025-10-06",
        "certification_date": "2025-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PA",
            "license": "PS020601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southampton, PA

Sources for this page

Verify at the official NPI Registry.