Active NPI
Kelly Gerhardstein, PSYD
- Psychologist
- Coatesville, PA
National Provider Identifier
1760610216
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 020196
- Practice address
- 1400 Blackhorse Hill Rd
Coatesville, PA 19320-2040 - Phone
- (610) 384-7711
- NPI assigned
- Jun 23, 2009
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 020196 | NY | Primary |
| Psychologist | 103T00000X | 1171 | LA |
Addresses
Primary practice location
1400 Blackhorse Hill Rd
Coatesville, PA 19320-2040
Mailing address
1400 Blackhorse Hill Rd
BLDG 27N
Coatesville, PA 19320-2040
Phone (610) 384-7711
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 |
|---|---|---|---|
| 1171 | LA | MD | Psychologist |
| 020196 | NY | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1245715200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1403222400000",
"number": "1760610216",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1400 BLACKHORSE HILL RD",
"address_2": "BLDG 27N",
"city": "COATESVILLE",
"state": "PA",
"postal_code": "193202040",
"telephone_number": "610-384-7711"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 BLACKHORSE HILL RD",
"city": "COATESVILLE",
"state": "PA",
"postal_code": "193202040",
"telephone_number": "610-384-7711"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GERHARDSTEIN",
"first_name": "KELLY",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-06-23",
"last_updated": "2014-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "020196",
"primary": true
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "LA",
"license": "1171",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Coatesville, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.