Active NPI
Caroline B. Kohl, PSY.D.
- Psychologist
- Elwyn, PA
National Provider Identifier
1609947936
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PS015483
- Practice address
- 111 Elwyn Rd
Elwyn, PA 19063-4622 - Phone
- (610) 891-7036
- NPI assigned
- Nov 10, 2006
- Last updated
- Sep 8, 2021
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | PS015483 | PA | Primary |
Addresses
Primary practice location
111 Elwyn Rd
Elwyn, PA 19063-4622
Mailing address
107 Bowater CT
Media, PA 19063-5528
Phone (610) 209-3591
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 103387909001 | Medicaid | PA |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS015483 | PA | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Elwyn of Pennsylvania and Delaware | Past | Accepting new patients | |
| David a Thomas, LTD | Psychologist | Past | Accepting new patients |
| Regional Medical Specialty Associates | Psychologist | Past | Accepting new patients |
| Elwyn of Pennsylvania and Delaware | Psychologist | Past | Accepting new patients |
Organizations & group practices 4
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.
-
- Community/Behavioral Health Agency
- Media, PA
- NPI 1215548615
-
dba Elwyn Mental Health Services
- Community/Behavioral Health Agency
- Philadelphia, PA
- NPI 1972643203
Psychologist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163116800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1631059200000",
"number": "1609947936",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "107 BOWATER CT",
"city": "MEDIA",
"state": "PA",
"postal_code": "190635528",
"telephone_number": "610-209-3591"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 ELWYN RD",
"city": "ELWYN",
"state": "PA",
"postal_code": "190634622",
"telephone_number": "610-891-7036"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOHL",
"first_name": "CAROLINE",
"middle_name": "B.",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-10",
"last_updated": "2021-09-08",
"certification_date": "2021-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "PA",
"license": "PS015483",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "103387909001",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Elwyn, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.