Active NPI
Jean A Deters, PSY.D.
- Clinical Psychologist
- Erlanger, KY
National Provider Identifier
1710043203
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1391
- Practice address
- 34 Erlanger Rd
Erlanger, KY 41018-1728 - Phone
- (859) 341-5782
- Fax
- (859) 341-5783
- NPI assigned
- Dec 29, 2006
- Last updated
- Jul 8, 2007
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 1391 | KY | Primary |
Addresses
Primary practice location
34 Erlanger Rd
Erlanger, KY 41018-1728
Mailing address
34 Erlanger Rd
Erlanger, KY 41018-1728
Phone (859) 341-5782
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1391 | KY | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Connor and Associates | Clinical | Past | Accepting new patients |
| Critical Stress & Wellness Center, LLC | Clinical | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Clinical Psychologist
- Erlanger, KY
- NPI 1417093915
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167350400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1710043203",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "34 ERLANGER RD",
"city": "ERLANGER",
"state": "KY",
"postal_code": "410181728",
"telephone_number": "859-341-5782",
"fax_number": "859-341-5783"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "34 ERLANGER RD",
"city": "ERLANGER",
"state": "KY",
"postal_code": "410181728",
"telephone_number": "859-341-5782",
"fax_number": "859-341-5783"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DETERS",
"first_name": "JEAN",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "KY",
"license": "1391",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Erlanger, KY
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.