Active NPI
Rachel Undercoffer, ED.S
- School Psychologist
- Streetsboro, OH
National Provider Identifier
1841919271
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- SP.00629
- Practice address
- 899 Frost Rd
Streetsboro, OH 44241-4355 - Phone
- (330) 963-8600
- NPI assigned
- Aug 29, 2022
- 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 |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | SP.00629 | OH | Primary |
Addresses
Primary practice location
899 Frost Rd
Streetsboro, OH 44241-4355
Mailing address
1210 Jasmine Dr Apt B
Kent, OH 44240-8608
Phone (330) 241-0249
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 |
|---|---|---|---|
| SP.00629 | OH | MD | School Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kidslink Connect, LLC | Single Specialty | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1661731200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661731200000",
"number": "1841919271",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1210 JASMINE DR APT B",
"city": "KENT",
"state": "OH",
"postal_code": "442408608",
"telephone_number": "330-241-0249"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "899 FROST RD",
"city": "STREETSBORO",
"state": "OH",
"postal_code": "442414355",
"telephone_number": "330-963-8600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "UNDERCOFFER",
"first_name": "RACHEL",
"credential": "ED.S",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-08-29",
"last_updated": "2022-08-29",
"certification_date": "2022-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Psychologist, School",
"state": "OH",
"license": "SP.00629",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Streetsboro, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.