Active NPI
Kathleen Corcoran, PSY.D.
- Clinical Psychologist
- Weston, FL
National Provider Identifier
1588862767
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 7831
- Practice address
- 2893 Executive Park Dr
Suite 107
Weston, FL 33331-3664 - Phone
- (305) 297-1926
- NPI assigned
- Jul 10, 2007
- Last updated
- Jun 10, 2016
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 7831 | FL | Primary |
Addresses
Primary practice location
2893 Executive Park Dr
Suite 107
Weston, FL 33331-3664
Mailing address
2893 Executive Park Dr
Suite 107
Weston, FL 33331-3664
Phone (305) 297-1926
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 1, 2024 through Apr 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7831 | FL | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184025600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1465516800000",
"number": "1588862767",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2893 EXECUTIVE PARK DR",
"address_2": "SUITE 107",
"city": "WESTON",
"state": "FL",
"postal_code": "333313664",
"telephone_number": "305-297-1926"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2893 EXECUTIVE PARK DR",
"address_2": "SUITE 107",
"city": "WESTON",
"state": "FL",
"postal_code": "333313664",
"telephone_number": "305-297-1926"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORCORAN",
"first_name": "KATHLEEN",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-07-10",
"last_updated": "2016-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "FL",
"license": "7831",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Weston, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2016; 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.