Individual provider Active NPI

Laurel Kasimor Cofell, PH.D.

  • Psychologist
  • Bethesda, MD
National Provider Identifier
1104126903
Registry record updated Sep 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
05134 Issued in MD
Practice address
8901 Wisconsin Ave
Behavioral Health Clinic, 6TH Floor America BLDG
Bethesda, MD 20889-0004
Phone
(301) 295-0500
NPI assigned
Oct 26, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 05134 MD Primary

Addresses

Primary practice location

8901 Wisconsin Ave
Behavioral Health Clinic, 6TH Floor America BLDG
Bethesda, MD 20889-0004

Mailing address

8901 Wisconsin Ave
Behavioral Health Clinic, 6TH Floor America BLDG
Bethesda, MD 20889-0004
Phone (301) 295-0500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
05134MDMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1288051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347321600000",
    "number": "1104126903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8901 WISCONSIN AVE",
            "address_2": "BEHAVIORAL HEALTH CLINIC, 6TH FLOOR AMERICA BLDG",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208890004",
            "telephone_number": "301-295-0500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8901 WISCONSIN AVE",
            "address_2": "BEHAVIORAL HEALTH CLINIC, 6TH FLOOR AMERICA BLDG",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208890004",
            "telephone_number": "301-295-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COFELL",
        "first_name": "LAUREL",
        "middle_name": "KASIMOR",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-26",
        "last_updated": "2012-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MD",
            "license": "05134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2012; 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.