Dylan Alexander Corp, PHD

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

PS019120 Issued in PA

Practice address

474 Windmere Dr Ste 301
State College, PA 16801-7651

Phone

(814) 826-3834

Fax

(814) 325-7331

NPI assigned

Sep 28, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

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

Specialty

Clinical Psychologist

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1601251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627344000000",
    "number": "1124635891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "474 WINDMERE DR STE 301",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168017651",
            "telephone_number": "814-826-3834",
            "fax_number": "814-325-7331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "474 WINDMERE DR STE 301",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168017651",
            "telephone_number": "814-826-3834",
            "fax_number": "814-325-7331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORP",
        "first_name": "DYLAN",
        "middle_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-09-28",
        "last_updated": "2021-07-27",
        "certification_date": "2021-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PA",
            "license": "PS019120",
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "PA",
            "license": "PS019120",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "PA",
            "license": "PS019120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marykathryn Corcoran, CRNP
• Amanda M. Cordero, PA-C
• Tyler Mark Corle, PHARMD
• John Mansfield Corneal III, DC
• Manuel Corona, PT, DPT, LAT, ATC
• Cosmetic Dentistry Inc
• Annamarie C Costlow, PA-C
• Counseling Alternatives Group, Inc
• Phuong Tran Courtney, PA
• Thomas E Covaleski, M.D.

• Counseling Psychologist in State College, PA
• Providers in State College, PA by specialty
• Counseling Psychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.