NPIMap

Organization Active NPI

Dr. Kenneth G. Small

  • Clinical Psychologist
  • Mechanicsburg, PA
National Provider Identifier
1487083226
Registry record updated Nov 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS004858-L Issued in PA
Legal business name
DR. KENNETH G. SMALL
Practice address
410 E Main St
Mechanicsburg, PA 17055-6515
Phone
(717) 795-8588
Fax
(717) 795-0541
NPI assigned
Nov 2, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2013

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

Authorized official

Name
Dr. Kenneth G Small, PH.D.NPI 1689676413
Title
Owner
Phone
(717) 795-8588

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X PS004858-L PA Primary

Addresses

Primary practice location

410 E Main St
Mechanicsburg, PA 17055-6515

Mailing address

410 E Main St
Mechanicsburg, PA 17055-6515
Phone (717) 795-8588

National Provider Directory

National Provider Directory

Locations

410 E Main St
Mechanicsburg, PA 17055
Phone (717) 795-8588

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1383350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383350400000",
    "number": "1487083226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 E MAIN ST",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170556515",
            "telephone_number": "717-795-8588",
            "fax_number": "717-795-0541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 E MAIN ST",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170556515",
            "telephone_number": "717-795-8588",
            "fax_number": "717-795-0541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. KENNETH G. SMALL",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-02",
        "last_updated": "2013-11-02",
        "status": "A",
        "authorized_official_last_name": "SMALL",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "717-795-8588",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS004858-L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mechanicsburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2013; 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.