James J Coupe III, PSY.D., MBA

Individual provider Active NPI Clinical Psychologist · Ardmore, PA

NPI 1255537809 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1255537809
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Psychologist 103TC0700X
License
PS015639 (PA)
Practice address
125 Coulter Ave
Ardmore, PA 19003-2410
Phone
(610) 642-4873
NPI assigned
Jun 21, 2007
Sex
Male
Sole proprietor
No

Organizations & group practices 2

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Business Administration

State licenses

LicenseStateTypeSpecialty
PS015639PAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
The Art of Friendship Social Skills Program, PC Past Accepting new patients
Center for Psychological Services Clinical Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PS015639 PA Yes

Addresses

Primary practice location

125 Coulter Ave
Ardmore, PA 19003-2410

Mailing address

103 Lincoln Cir
Broomall, PA 19008-1502
Phone (484) 422-8460

Other providers in Ardmore, PA

All providers in Ardmore, PA · Clinical Psychologist in Pennsylvania

Sources for this page

Verify at the official NPI Registry.