Individual provider Active NPI

Joyce Cooper-Kahn, PH.D.

  • Clinical Psychologist
  • Severna Park, MD
National Provider Identifier
1265556609
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2390 Issued in MD
Practice address
479 Jumpers Hole Rd
Suite 206
Severna Park, MD 21146-1600
Phone
(410) 647-8840
Fax
(410) 647-1405
NPI assigned
Mar 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 2390 MD Primary

Addresses

Primary practice location

479 Jumpers Hole Rd
Suite 206
Severna Park, MD 21146-1600

Mailing address

479 Jumpers Hole Rd
Suite 206
Severna Park, MD 21146-1600
Phone (410) 647-8840

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)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
2390MDMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265556609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "479 JUMPERS HOLE RD",
            "address_2": "SUITE 206",
            "city": "SEVERNA PARK",
            "state": "MD",
            "postal_code": "211461600",
            "telephone_number": "410-647-8840",
            "fax_number": "410-647-1405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "479 JUMPERS HOLE RD",
            "address_2": "SUITE 206",
            "city": "SEVERNA PARK",
            "state": "MD",
            "postal_code": "211461600",
            "telephone_number": "410-647-8840",
            "fax_number": "410-647-1405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER-KAHN",
        "first_name": "JOYCE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "2390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Severna Park, MD

Sources for this page

  • 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.