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CARLY KOENIG
NPI 1104782549
Psychologist - Clinical in Jb Andrews, MD

Active since December 30, 2025
1060 W PERIMETER RD, JB ANDREWS, MD 20762(240) 857-8964 Get Directions Write a Review

NPPES record last updated: December 30, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Carly Koenig NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CARLY KOENIG (NPI 1104782549) is an individual clinical provider in Jb Andrews, Maryland, licensed in Pennsylvania (PS020645) and active in the NPI registry since December 2025.

NPPES Registry Identity

NPI1104782549
Entity TypeIndividualFemale
Primary Taxonomy103TC0700X
Provider Legal NameCARLY KOENIG
Location Address1060 W PERIMETER RDJb Andrews, MD 20762-6602
Mailing Address8117 Burholme AvePhiladelphia, PA 19111-1810
Phone(240) 857-8964
Sole ProprietorNo
Enumeration DateDecember 30, 2025
NPPES CertifiedDecember 30, 2025
✔ NPI 1104782549 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in PA · PS020645
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
1060 W PERIMETER RD, Jb Andrews, MD 20762
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CHELSEA BIANCA PAYNE M.D.
Family Medicine
1060 W PERIMETER RD
JB ANDREWS, MD 20762
Prince George's County (907) 377-6722
MS. PATRICIA BANASZEK HAZARD CRNP
Nurse Practitioner (Obstetrics & Gynecology)
1060 W PERIMETER RD
JB ANDREWS, MD 20762
Prince George's County (240) 612-1400
MR. KOMI VENUNYE GAYAKPA IDC
Military Health Care Provider (Independent Duty Corpsman)
1060 W PERIMETER RD
JB ANDREWS, MD 20762
Prince George's County (651) 354-8825
AMANDA MARIE HAWKINS MD
Obstetrics & Gynecology
1060 W PERIMETER RD
JB ANDREWS, MD 20762
Prince George's County (240) 612-1400
DR. JULIE ANN BANTA PT, DPT, FAAOMPT
Physical Therapist
1060 W PERIMETER RD
JB ANDREWS, MD 20762
Prince George's County (240) 612-2464
DR. SUBODH ARORA MD
Pediatrics
1060 W PERIMETER RD
JB ANDREWS, MD 20762
Prince George's County (301) 404-9046
MR. JEREMY TROY POWELL PA-C
Physician Assistant
1060 W PERIMETER RD
JB ANDREWS, MD 20762
Prince George's County (240) 612-1143
CASSANDRA VERHOFF MS, RD, LDN
Dietitian, Registered
1060 W PERIMETER RD
JB ANDREWS, MD 20762
Prince George's County (240) 612-2678

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Carly Koenig's NPI number?

The NPI number for Carly Koenig is 1104782549. It was assigned to this individual provider in the NPPES registry on December 30, 2025.

Where is Carly Koenig located?

Carly Koenig practices at 1060 W Perimeter Rd, Jb Andrews, MD 20762. The listed phone number is (240) 857-8964.

What is Carly Koenig's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

When was this NPI record last updated?

The NPPES record for Carly Koenig was last updated on December 30, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.