Individual provider Active NPI

Cathy Sue Kogan, PHD

  • Psychologist
  • Pittsfield, MA
National Provider Identifier
1437222379
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
4698 Issued in MA
Practice address
19 Bartlett Avenue
Pittsfield, MA 01201-6301
Phone
(413) 499-2462
Fax
(413) 443-7957
NPI assigned
Nov 16, 2006
Last updated
Jul 8, 2007By the provider in NPPES
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
Psychologist 103T00000X 4698 MA Primary

Addresses

Primary practice location

19 Bartlett Avenue
Pittsfield, MA 01201-6301

Mailing address

19 Bartlett Avenue
Pittsfield, MA 01201-6301
Phone (413) 499-2462

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20101223000005 MA Practitioner - Clinical Psychologist 3678761228 Practice locations: Pittsfield, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
University of Massachusetts Medical School, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

222 S St
Pittsfield, MA 01201-6818

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
4698MAMDCounselor

NPI Registry JSON

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1437222379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 BARTLETT AVENUE",
            "city": "PITTSFIELD",
            "state": "MA",
            "postal_code": "012016301",
            "telephone_number": "413-499-2462",
            "fax_number": "413-443-7957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 BARTLETT AVENUE",
            "city": "PITTSFIELD",
            "state": "MA",
            "postal_code": "012016301",
            "telephone_number": "413-499-2462",
            "fax_number": "413-443-7957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOGAN",
        "first_name": "CATHY",
        "middle_name": "SUE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "4698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsfield, MA

Sources for this page

Verify at the official NPI Registry.