Active NPI
Kristine V. Spano, PSY.D.
- Clinical Psychologist
- Philadelphia, PA
National Provider Identifier
1467944470
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 018724
- Practice address
- 1528 Walnut St Ste 512
Philadelphia, PA 19102-3606 - Phone
- (267) 225-4122
- NPI assigned
- Jun 5, 2018
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 026023-01 | NY | |
| Clinical Psychologist | 103TC0700X | 018724 | PA | Primary |
Addresses
Primary practice location
1528 Walnut St Ste 512
Philadelphia, PA 19102-3606
Mailing address
1528 Walnut St Ste 512
Philadelphia, PA 19102-3606
Phone (201) 463-4487
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jul 1, 2024 through Jul 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 026023-01 | NY | MD | Clinical Psychologist |
| 018724 | PA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528156800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1782432000000",
"number": "1467944470",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1528 WALNUT ST STE 512",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191023606",
"telephone_number": "201-463-4487"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1528 WALNUT ST STE 512",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191023606",
"telephone_number": "267-225-4122"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPANO",
"first_name": "KRISTINE",
"middle_name": "V.",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-06-05",
"last_updated": "2026-06-26",
"certification_date": "2026-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "026023-01",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "PA",
"license": "018724",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.