Individual provider Active NPI

Cynthia L Kokoris, PSY D

  • Clinical Psychologist
  • Hampton, VA
National Provider Identifier
1528495751
Registry record updated Oct 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
0810004724 Issued in VA
Practice address
2202 Executive Dr
Suite C
Hampton, VA 23666-6604
Phone
(757) 827-7707
Fax
(757) 838-2573
NPI assigned
Oct 2, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 0810004724 VA Primary

Addresses

Primary practice location

2202 Executive Dr
Suite C
Hampton, VA 23666-6604

Mailing address

2202 Executive Drive
Suite C
Hampton, VA 23666

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20140131001878 VA Practitioner - Clinical Psychologist 9436388998 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Genesis Counseling Center, Inc.Group PAC ID 8729091715, 66 clinicians

Practice addresses (Care Compare)

6330 Newtown Rd
Suite 300
Norfolk, VA 23502-4805
Phone (757) 466-3336

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0810004724VAMDClinical Psychologist
0810004727VAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Genesis Counseling Center, Inc. Clinical CurrentSince Nov 16, 2013 Accepting new patients

Locations

638 Independence Pkwy
Ste 240
Chesapeake, VA 23320
Phone (757) 609-3677

2202 Executive Dr
Ste C
Hampton, VA 23666
Phone (757) 838-5055

2208 Executive Dr
Hampton, VA 23666
Phone (757) 720-2210

6330 Newtown Rd
Ste 300
Norfolk, VA 23502
Phone (757) 466-3336

223 McLaws Cir
Williamsburg, VA 23185
Phone (757) 564-3100

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1380672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380672000000",
    "number": "1528495751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2202 EXECUTIVE DRIVE",
            "address_2": "SUITE C",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "23666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2202 EXECUTIVE DR",
            "address_2": "SUITE C",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236666604",
            "telephone_number": "757-827-7707",
            "fax_number": "757-838-2573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOKORIS",
        "first_name": "CYNTHIA",
        "middle_name": "L",
        "credential": "PSY D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-02",
        "last_updated": "2013-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810004724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hampton, VA

Sources for this page

Verify at the official NPI Registry.