Individual provider Active NPI

Kenneth William Volk III, PSY.D.

  • Clinical Psychologist
  • Philadelphia, PA
National Provider Identifier
1669821096
Registry record updated Nov 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS019125 Issued in PA
Practice address
255 S 17TH St Ste 1900
Philadelphia, PA 19103-6231
Phone
(267) 209-3727
NPI assigned
Jun 7, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2023

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 PS019125 PA Primary

Addresses

Primary practice location

255 S 17TH St Ste 1900
Philadelphia, PA 19103-6231

Mailing address

331 Wayne Ave
Springfield, PA 19064-2602
Phone (410) 733-2748

Other practice location 1

331 Wayne Ave
Springfield, PA 19064-2602
Phone (410) 733-2748

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20240217000352 PA Practitioner - Clinical Psychologist 1658715636 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Philadelphia Center for PsychotherapyGroup PAC ID 7416341474, 13 clinicians

Practice addresses (Care Compare)

255 S 17TH St
Suite 1900
Philadelphia, PA 19103-6216
Phone (267) 277-3179

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PS019125PAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Philadelphia Center for Psychotherapy CurrentSince Jan 1, 2024 Accepting new patients

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": "1465257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699833600000",
    "number": "1669821096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 WAYNE AVE",
            "city": "SPRINGFIELD",
            "state": "PA",
            "postal_code": "190642602",
            "telephone_number": "410-733-2748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 S 17TH ST STE 1900",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191036231",
            "telephone_number": "267-209-3727"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "331 Wayne Ave",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "PA",
            "postal_code": "190642602",
            "country_code": "US",
            "telephone_number": "410-733-2748",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VOLK",
        "first_name": "KENNETH",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-07",
        "last_updated": "2023-11-13",
        "certification_date": "2023-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS019125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.