Marylynne Kemperman Black, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

TPS 029985 Issued in PA

Practice address

642 Cowpath Road #393
Lansdale, PA 19446

Phone

(215) 361-6959

Fax

(215) 361-6195

NPI assigned

Apr 19, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA, VA2 enrollments

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 2

Specialty

Clinical Psychologist

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Sailor Health Medical PAGroup PAC ID 4486182342, 301 clinicians

Penn Foundation IncGroup PAC ID 0446246011, 25 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Penn Foundation Inc

  • Community/Behavioral Health Agency
  • Sellersville, PA
  • NPI 1073572715
  Medicare reassignment Care Compare group NPD
• Sailor Health Medical PA

  • Psychologist
  • Coral Gables, FL
  • NPI 1841012960

  VA

  Medicare reassignment Care Compare group NPD
• Perkiomen Counseling Services LLC

  • Community/Behavioral Health Agency
  • Perkiomenville, PA
  • NPI 1881861912
  Authorized official Same address or phone

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508083742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 HILDEBRANDT ROAD",
            "city": "PERKIOMENVILLE",
            "state": "PA",
            "postal_code": "180749504",
            "telephone_number": "610-754-7608",
            "fax_number": "610-754-7608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "642 COWPATH ROAD #393",
            "city": "LANSDALE",
            "state": "PA",
            "postal_code": "19446",
            "telephone_number": "215-361-6959",
            "fax_number": "215-361-6195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "MARYLYNNE",
        "middle_name": "KEMPERMAN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "TPS 029985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Theresa M Bigelow, CRNP
• Donna Rose Birster, LPN
• Victoria Marie Bittone, PT, DPT
• BJ's Wholesale Club Inc.
• Lawrence B Black, D.D.S.
• Sherri E Blackstone, MD
• Lee M Blatstein, DO
• Blue Mountain Wellness, PLLC
• Nina Sheppard Boal, MD
• Louise M Bolte, CRNP

• Clinical Psychologist in Lansdale, PA
• Providers in Lansdale, PA by specialty
• Clinical Psychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.