Active NPI
Karen Graham Doberneck, PHD, BCBA-D
- Psychologist
- Lewistown, PA
National Provider Identifier
1871923391
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- BH000019
- Practice address
- 25 N. Main Street
Lewistown, PA 17044 - Phone
- (717) 242-3590
- Fax
- (717) 242-3590
- NPI assigned
- Nov 19, 2013
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | BH000019 | PA | Primary |
Addresses
Primary practice location
25 N. Main Street
Lewistown, PA 17044
Mailing address
25 N. Main Street
Lewistown, PA 17044
Phone (717) 242-3590
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 |
|---|---|---|---|
| BH000019 | PA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1384819200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1384819200000",
"number": "1871923391",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25 N. MAIN STREET",
"city": "LEWISTOWN",
"state": "PA",
"postal_code": "17044",
"telephone_number": "717-242-3590",
"fax_number": "717-242-3590"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25 N. MAIN STREET",
"city": "LEWISTOWN",
"state": "PA",
"postal_code": "17044",
"telephone_number": "717-242-3590",
"fax_number": "717-242-3590"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOBERNECK",
"first_name": "KAREN",
"middle_name": "GRAHAM",
"credential": "PHD, BCBA-D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-11-19",
"last_updated": "2013-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "PA",
"license": "BH000019",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lewistown, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.