Active NPI
Stephanie Adam, PSYD
- Clinical Psychologist
- Coatesville, PA
National Provider Identifier
1174800528
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PS017824
- Practice address
- 1400 Blackhorse Hill Rd
Coatesville, PA 19320-2040 - Phone
- (610) 384-7711
- NPI assigned
- Nov 14, 2011
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | T-LP 2008 | KS | |
| Clinical Psychologist | 103TC0700X | PS017824 | PA | Primary |
Addresses
Primary practice location
1400 Blackhorse Hill Rd
Coatesville, PA 19320-2040
Mailing address
55 Hatchetts Hill Rd
Old Lyme, CT 06371-1534
Phone (800) 370-3651
Other practice location 1
2595 Interstate Dr. Suite 103
Harrisburg, PA 17110-9380
Phone (800) 370-3651 ext. 1145
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| T-LP 2008 | KS | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1321228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1174800528",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "55 HATCHETTS HILL RD",
"city": "OLD LYME",
"state": "CT",
"postal_code": "063711534",
"telephone_number": "800-370-3651",
"fax_number": "877-515-7147"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 BLACKHORSE HILL RD",
"city": "COATESVILLE",
"state": "PA",
"postal_code": "193202040",
"telephone_number": "610-384-7711"
}
],
"practiceLocations": [
{
"address_1": "2595 Interstate Dr. Suite 103",
"address_purpose": "LOCATION",
"city": "Harrisburg",
"state": "PA",
"postal_code": "171109380",
"country_code": "US",
"telephone_number": "800-370-3651 x1145",
"fax_number": "877-515-7147",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ADAM",
"first_name": "STEPHANIE",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-11-14",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "KS",
"license": "T-LP 2008",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "PA",
"license": "PS017824",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Coatesville, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.