Active NPI
Kenneth Wayne Covelman, PH.D.
- Clinical Psychologist
- Philadelphia, PA
National Provider Identifier
1710180716
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PS002456L
- Practice address
- 4025 Chestnut St
Council for Relationships
Philadelphia, PA 19104-3054 - Phone
- (215) 382-6680
- Fax
- (215) 386-1743
- NPI assigned
- Jun 7, 2007
- Sex
- Male
- 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 | PS002456L | PA | Primary |
Addresses
Primary practice location
4025 Chestnut St
Council for Relationships
Philadelphia, PA 19104-3054
Mailing address
1146 Ann Dr
Cherry Hill, NJ 08003-2721
Phone (856) 354-0137
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PS002456L | Other | PA | PSYCHOLOGY LICENSE NUMBER |
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS002456L | PA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181174400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1710180716",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1146 ANN DR",
"city": "CHERRY HILL",
"state": "NJ",
"postal_code": "080032721",
"telephone_number": "856-354-0137"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4025 CHESTNUT ST",
"address_2": "COUNCIL FOR RELATIONSHIPS",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191043054",
"telephone_number": "215-382-6680",
"fax_number": "215-386-1743"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COVELMAN",
"first_name": "KENNETH",
"middle_name": "WAYNE",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-06-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "PA",
"license": "PS002456L",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PSYCHOLOGY LICENSE NUMBER",
"identifier": "PS002456L",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
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.