Individual provider Active NPI

Taylor J Pauken, PSY.D., LCP

  • Clinical Psychologist
  • Virginia Beach, VA
National Provider Identifier
1487259180
Registry record updated Dec 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
0810007312 Issued in VA
Practice address
641 Carriage Hill Rd
Virginia Beach, VA 23452-6518
Phone
(757) 563-3147
NPI assigned
Dec 1, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent Psychologist 103TC2200X 0810007312 VA
Clinical Psychologist 103TC0700X 0810007312 VA Primary

Addresses

Primary practice location

641 Carriage Hill Rd
Virginia Beach, VA 23452-6518

Mailing address

442 Marsh Duck Way
Virginia BCH, VA 23451-6556

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0810007312VAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1606780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606780800000",
    "number": "1487259180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "442 MARSH DUCK WAY",
            "city": "VIRGINIA BCH",
            "state": "VA",
            "postal_code": "234516556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "641 CARRIAGE HILL RD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234526518",
            "telephone_number": "757-563-3147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAUKEN",
        "first_name": "TAYLOR",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "PSY.D., LCP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-01",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "VA",
            "license": "0810007312",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810007312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2020; 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.