Active NPI
Katherine Tierney Roberts, PHD
- Clinical Psychologist
- Glenmoore, PA
National Provider Identifier
1801277512
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PS018566
- Practice address
- 9 Ashlea Dr
Glenmoore, PA 19343 - Phone
- (804) 687-9656
- NPI assigned
- Jun 18, 2015
- Last updated
- Aug 13, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 | PS018566 | PA | Primary |
Addresses
Primary practice location
9 Ashlea Dr
Glenmoore, PA 19343
Mailing address
Massachusetts General Hospital
55 Fruit St.
Boston, MA 02114
Phone (617) 726-2066
Other names 1
- Kathryn Tierney Roberts
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 |
|---|---|---|---|
| PS018566 | PA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1434585600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1534118400000",
"number": "1801277512",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "MASSACHUSETTS GENERAL HOSPITAL",
"address_2": "55 FRUIT ST.",
"city": "BOSTON",
"state": "MA",
"postal_code": "02114",
"telephone_number": "617-726-2066"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9 ASHLEA DR",
"city": "GLENMOORE",
"state": "PA",
"postal_code": "19343",
"telephone_number": "804-687-9656"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "KATHERINE",
"middle_name": "TIERNEY",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-06-18",
"last_updated": "2018-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Psychologist, Clinical",
"state": "PA",
"license": "PS018566",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KATHRYN",
"last_name": "ROBERTS",
"middle_name": "TIERNEY",
"code": "5",
"type": "Other Name"
}
]
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.