Peter Lynn Kingan, PH.D.

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

0011037 Issued in NY

Practice address

31 Oak St
21
Patchogue, NY 11772-2887

Phone

(631) 447-6425

Fax

(631) 776-8027

NPI assigned

Aug 31, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235240367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 OAK ST",
            "address_2": "21",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117722887",
            "telephone_number": "631-447-6425",
            "fax_number": "631-776-8027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 OAK ST",
            "address_2": "21",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117722887",
            "telephone_number": "631-447-6425",
            "fax_number": "631-776-8027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINGAN",
        "first_name": "PETER",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "NY",
            "license": "0011037",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS/CHAMPVA",
            "identifier": "Y042249",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01386290",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Marlana King
• Kimberly Kinghorn
• Dianne Patricia Kirk, PTA
• Michael Kirk, D.O.
• Ryan Scott Kirschner
• Kimberly Klappert, LCSW

• Counseling Psychologist in Patchogue, NY
• Providers in Patchogue, NY by specialty
• Counseling Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.