DR. VIRGINIA M. KOUTSOUROS


Address: 5619-25 Vine Street, Philadelphia, PA 19139-1302
Phone: 2154712761

DR. VIRGINIA M. KOUTSOUROS (NPI# 1609982982) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1609982982
Entity Type Individual
Full Name DR. VIRGINIA M. KOUTSOUROS
Credential PSY.D.
Practice Address 5619-25 Vine Street
Philadelphia
PA 19139-1302
Mailing Address 1006 Stratford Ave
Melrose Park
PA 19027-3025
Practice Telephone 2154712761
Practice Fax Number 2154712929
Mailing Telephone 2157828972
Mailing Fax Number 2156353087
Enumeration Date 2006-08-21
Last Update Date 2013-04-10
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103T00000X Psychologist PS015772 PA Behavioral Health & Social Service Providers

Office Location

Street Address 5619-25 VINE STREET
City PHILADELPHIA
State PA
Zip Code 19139-1302

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Taxonomy Information

Taxonomy Code 103T00000X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist

Taxonomy Definition

A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
Notes: Source: American Psychological Association [1/1/2007: modified definition]

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NPI Name Taxonomy Address Enumeration
1619578937 Margaret Edwards Psychologist 110 S 20th St Ste 206, Philadelphia, PA 19103-4486 2020-11-03
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1912518226 Karen Dybner-madero Psychologist 2201 Pennsylvania Avenue, The Parkway House, Suite 101, Philadelphia, PA 19130 2020-08-11
1659980621 Corinne Masur Psychologist 1601 Walnut St Ste 1408, Philadelphia, PA 19102-2909 2020-07-27
1730798067 Amanda Marie Large Psychologist 1516 N 5th St Unit 401, Philadelphia, PA 19122-3679 2020-07-22
1295355543 Jennifer Ann Engelhardt Psychologist 8201 Henry Ave Apt Q15, Philadelphia, PA 19128-2248 2020-04-16
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1811530512 Tower Drexel Academic Medical Group LLC Psychologist 1427 Vine St Fl 1, Philadelphia, PA 19102-1031 2019-10-25
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City PHILADELPHIA
Zip Code 19139

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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