Active NPI
Shana Golembo Dodge, PHD
- Clinical Psychologist
- King of Prussia, PA
National Provider Identifier
1831057538
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 26064
- Practice address
- 2700 Horizon Dr Ste 120
King of Prussia, PA 19406-2726 - Phone
- (484) 584-0152
- NPI assigned
- Jan 12, 2026
- 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 | 26064 | CA | Primary |
Addresses
Primary practice location
2700 Horizon Dr Ste 120
King of Prussia, PA 19406-2726
Mailing address
2700 Horizon Dr Ste 120
King of Prussia, PA 19406-2726
Phone (484) 584-0152
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1768176000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1768176000000",
"number": "1831057538",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2700 HORIZON DR STE 120",
"city": "KING OF PRUSSIA",
"state": "PA",
"postal_code": "194062726",
"telephone_number": "484-584-0152"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2700 HORIZON DR STE 120",
"city": "KING OF PRUSSIA",
"state": "PA",
"postal_code": "194062726",
"telephone_number": "484-584-0152"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DODGE",
"first_name": "SHANA",
"middle_name": "GOLEMBO",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2026-01-12",
"last_updated": "2026-01-12",
"certification_date": "2026-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "26064",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in King of Prussia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.