Active NPI
Letitia Danielle Kouvatas, PSY.D.
- Clinical Psychologist
- Philadelphia, PA
National Provider Identifier
1104332352
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PS016239
- Practice address
- 499 N 5TH St Ste D&E
Philadelphia, PA 19123-4005 - Phone
- (215) 408-4910
- NPI assigned
- Dec 26, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PS016239 | PA | Primary |
Addresses
Primary practice location
499 N 5TH St Ste D&E
Philadelphia, PA 19123-4005
Mailing address
29 Kings Highway East
Haddonfield, NJ 08033
Phone (856) 296-3183
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1514246400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1514246400000",
"number": "1104332352",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29 KINGS HIGHWAY EAST",
"city": "HADDONFIELD",
"state": "NJ",
"postal_code": "08033",
"telephone_number": "856-296-3183"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "499 N 5TH ST STE D&E",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191234005",
"telephone_number": "215-408-4910"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOUVATAS",
"first_name": "LETITIA",
"middle_name": "DANIELLE",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-12-26",
"last_updated": "2017-12-26",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "PA",
"license": "PS016239",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.