Active NPI
Kendall Michelle Corcoran, PSYD
- Psychologist
- Stony Brook, NY
National Provider Identifier
1235957200
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 026733
- Practice address
- 169 Putnam Hall
Stony Brook, NY 11794-0001 - Phone
- (631) 632-8850
- NPI assigned
- Sep 30, 2024
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 026733 | NY | Primary |
Addresses
Primary practice location
169 Putnam Hall
Stony Brook, NY 11794-0001
Mailing address
169 Putnam Hall
Stony Brook, NY 11794-0001
Phone (631) 632-8850
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
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": "1727654400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727654400000",
"number": "1235957200",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "169 PUTNAM HALL",
"city": "STONY BROOK",
"state": "NY",
"postal_code": "117940001",
"telephone_number": "631-632-8850"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "169 PUTNAM HALL",
"city": "STONY BROOK",
"state": "NY",
"postal_code": "117940001",
"telephone_number": "631-632-8850"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORCORAN",
"first_name": "KENDALL",
"middle_name": "MICHELLE",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-09-30",
"last_updated": "2024-09-30",
"certification_date": "2024-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "026733",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stony Brook, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2024; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.