Individual provider Active NPI

Yvette Danielle Kovner, PSYD.

  • Clinical Psychologist
  • Cambridge, MD
National Provider Identifier
1346401304
Registry record updated Nov 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
05971 Issued in MD
Practice address
5262 Woods Rd
Cambridge, MD 21613-3796
Phone
(410) 221-2340
NPI assigned
Jun 23, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2024

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 05971 MD Primary

Addresses

Primary practice location

5262 Woods Rd
Cambridge, MD 21613-3796

Mailing address

7213 Chatham Manor Way
Pittsville, MD 21850-2097
Phone (978) 290-0326

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241205002798 MD Practitioner - Clinical Psychologist 8123554706 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
05971MDMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Comptroller of Maryland Central Payroll Bureau CurrentSince Sep 23, 2024 Accepting new patients
State of Maryland Central Payroll Bureau CurrentSince Sep 23, 2024 Accepting new patients
Comptroller of Maryland Central Payroll Bureau Current Accepting new patients
Comptroller of Maryland Central Payroll Bureau Past Accepting new patients

Locations

300 W Preston St
Ste 402
Baltimore, MD 21201
Phone (410) 767-2940

5262 Woods Rd
Cambridge, MD 21613
Phone (410) 221-2300

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1214179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732147200000",
    "number": "1346401304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7213 CHATHAM MANOR WAY",
            "city": "PITTSVILLE",
            "state": "MD",
            "postal_code": "218502097",
            "telephone_number": "978-290-0326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5262 WOODS RD",
            "city": "CAMBRIDGE",
            "state": "MD",
            "postal_code": "216133796",
            "telephone_number": "410-221-2340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOVNER",
        "first_name": "YVETTE",
        "middle_name": "DANIELLE",
        "credential": "PSYD.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-23",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "05971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MD

Sources for this page

Verify at the official NPI Registry.