Active NPI
Stewart Hockenberry, PH.D.
- Counseling Psychologist
- Philadelphia, PA
National Provider Identifier
1881750271
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- PS008448L
- Practice address
- 255 S 17TH St Ste 1909
Philadelphia, PA 19103-6219 - Phone
- (215) 576-1728
- Fax
- (215) 576-1728
- NPI assigned
- Dec 29, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | PS008448L | PA | Primary |
Addresses
Primary practice location
255 S 17TH St Ste 1909
Philadelphia, PA 19103-6219
Mailing address
409 Carlton Ave
Wyncote, PA 19095-2015
Phone (215) 576-1728
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 243596 | Other | PA | MANAGED HEALTH NETWORK |
| 0102891000 | Other | PA | PERSONAL CHOICE PROVIDER |
| 7543181 | Other | PA | AETNA HEALTH CARE |
| H0122450 | Other | PA | INDEPENDENCE BLUE CROSS |
| 158128 | Other | PA | VALUE OPTIONS |
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS008448L | PA | MD | Counseling Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167350400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1881750271",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "409 CARLTON AVE",
"city": "WYNCOTE",
"state": "PA",
"postal_code": "190952015",
"telephone_number": "215-576-1728",
"fax_number": "215-576-1728"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "255 S 17TH ST STE 1909",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191036219",
"telephone_number": "215-576-1728",
"fax_number": "215-576-1728"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOCKENBERRY",
"first_name": "STEWART",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "PA",
"license": "PS008448L",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MANAGED HEALTH NETWORK",
"identifier": "243596",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PERSONAL CHOICE PROVIDER",
"identifier": "0102891000",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA HEALTH CARE",
"identifier": "7543181",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INDEPENDENCE BLUE CROSS",
"identifier": "H0122450",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS",
"identifier": "158128",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.