Individual provider Active NPI

Katelyn Van Doorn, PSYD

  • Psychologist
  • Dover, NH
National Provider Identifier
1184075384
Registry record updated May 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
1630 Issued in NH
Practice address
10 Members Way Ste 300
Dover, NH 03820-5933
Phone
(603) 749-0913
NPI assigned
Jun 29, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Psychologist 103T00000X 1630 NH Primary

Addresses

Primary practice location

10 Members Way Ste 300
Dover, NH 03820-5933

Mailing address

PO Box 412503
Boston, MA 02241-2620
Phone (617) 726-3884

Other practice location 1

735 North Dr
Hopkinsville, KY 42240-2620
Phone (270) 886-5163

Other practice location 2

73 Corporate Dr Ste 200
Portsmouth, NH 03801-2847
Phone (603) 610-8075

Other identifiers 1

IdentifierTypeStateIssuer
3139079MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20230207000261 NH Practitioner - Clinical Psychologist 6901278621 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wentworth Douglass Physician CorporationGroup PAC ID 5496749848, 429 clinicians

Practice addresses (Care Compare)

10 Members Way
300 Coastal Neurology Services
Dover, NH 03820-5933
Phone (603) 749-0913

Hospital & facility affiliations

  • Wentworth-Douglass Hospital Hospital, Dover, NH, CCN 300018

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Wentworth Douglass Physician Corporation CurrentSince Feb 27, 2023 Accepting new patients
Wentworth Douglass Hospital Current Accepting new patients
Wentworth Douglass Physician Corporation CurrentSince Feb 27, 2023 Accepting new patients

Locations

10 Members Way
Ste 300
Dover, NH 03820
Phone (603) 742-7222

789 Central Ave
Dover, NH 03820
Phone (603) 740-2832

73 Corporate Dr
Ste 200
Portsmouth, NH 03801
Phone (603) 610-8050

121 Corporate Dr
Bldg C
Portsmouth, NH 03801
Phone (603) 740-8787

73 Corporate Dr
Portsmouth, NH 03801
Phone (603) 516-1307

Interoperability endpoints

  • Direct secure messaging: yunes.katelyn.wdh@direct.partners.masshiway.net

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1467158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747094400000",
    "number": "1184075384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 412503",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022412620",
            "telephone_number": "617-726-3884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 MEMBERS WAY STE 300",
            "city": "DOVER",
            "state": "NH",
            "postal_code": "038205933",
            "telephone_number": "603-749-0913"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "735 North Dr",
            "address_purpose": "LOCATION",
            "city": "Hopkinsville",
            "state": "KY",
            "postal_code": "422402620",
            "country_code": "US",
            "telephone_number": "270-886-5163",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "73 Corporate Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "Portsmouth",
            "state": "NH",
            "postal_code": "038012847",
            "country_code": "US",
            "telephone_number": "603-610-8075",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAN DOORN",
        "first_name": "KATELYN",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-29",
        "last_updated": "2025-05-13",
        "certification_date": "2025-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NH",
            "license": "1630",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3139079",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, NH

Sources for this page

Verify at the official NPI Registry.