Active NPI
Kay Lynn Gendron, PH.D.
- Psychologist
- Honesdale, PA
National Provider Identifier
1306866942
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PS-004675L
- Practice address
- 955 Main St
Honesdale, PA 18431-1903 - Phone
- (570) 253-2171
- Fax
- (570) 253-7788
- NPI assigned
- Jul 19, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PS-004675L | PA | Primary |
| Psychologist | 103T00000X | LP3065 | MN |
Addresses
Primary practice location
955 Main St
Honesdale, PA 18431-1903
Mailing address
955 Main St
Honesdale, PA 18431-1903
Phone (570) 253-2171
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: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Jan 1, 2019 through Jan 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP3065 | MN | MD | Psychologist |
| PS-004675L | PA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1306866942",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "955 MAIN ST",
"city": "HONESDALE",
"state": "PA",
"postal_code": "184311903",
"telephone_number": "570-253-2171",
"fax_number": "570-253-7788"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "955 MAIN ST",
"city": "HONESDALE",
"state": "PA",
"postal_code": "184311903",
"telephone_number": "570-253-2171",
"fax_number": "570-253-7788"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GENDRON",
"first_name": "KAY",
"middle_name": "LYNN",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "PA",
"license": "PS-004675L",
"primary": true
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MN",
"license": "LP3065",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Honesdale, PA
- Jacqueline Brooke Gallik, MS OTR/L
- Lisa Shea Gambini, DEM
- Bridget Garcia Babcock, CPHT
- Morgan Leigh Gasper, PA
- Geisinger Clinic (PrimeMed Medical Grp Honesdale in collaboration w/ Geisinger Clinic)
- Melissa Marie Gibblets, MS, OTRL
- Francie Faun Gilchrist, CERTIFIED DOULA
- Carrie Gager Gill, LPC, LBS
- Harris Rahman Gill, MD
- Emebet Tilahun Giref, MSPT
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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.