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Deactivated NPI 1265408744 Deactivated / Inactive NPI Male Practitioner

Dr. Jay Stefan Gorban , PhD

Psychologist - Clinical • Ft. Campbell, KY

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Jay Gorban has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date February 24, 2006
NPI Deactivation Date March 01, 2021
Total Practice Duration ~15 Years of Practice (2006 – 2021)

Professional Overview & Biography Verified Profile Summary

Dr. Jay Gorban, PhD was a registered Psychologist - Clinical practicing in Ft. Campbell, KY. Throughout an active medical career spanning 15 years, Dr. Gorban provided care at the practice location at 650 JOEL DR until profile deactivation on 2021-03-01.

Practice Location & Contact Primary Location

Practice Address

650 Joel Dr
Blanchfield Army Community Hospital

Ft. Campbell, KY 422235349

Telephone 2707988372

Specialty Benchmarks & Practice Insights

Comparative analytics for Psychologist - Clinical in Ft. Campbell, KY

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 19.3 Yrs
Regional Practice Density
3 Specialists

Practicing in Ft. Campbell, KY (750 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Psychologist - Clinical Primary Specialty

NUCC Taxonomy Code: 103TC0700X

State License KY 718

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.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Vivian Fivecoat

Registered Nurse - Emergency

NPI 1003874579
Dr. Eric Berg , MD

Pathology - Anatomic Pathology & Clinical Pathology

NPI 1013983543

Doctor of Medicine (M.D.)

NPI 1023077724

Doctor of Medicine (M.D.)

Walter Herrmann , MA

Counselor - Mental Health

NPI 1023084506

Master of Arts

Douglas Henry

Pediatrics

NPI 1033185806
Opal Galloway , LCSW

Social Worker - Clinical

NPI 1043286719

Licensed Clinical Social Worker

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated March 01, 2021

Record deactivated on March 01, 2021

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 650 JOEL DR, BLANCHFIELD ARMY COMMUNITY HOSPITAL, FT. CAMPBELL, KY 422235349 (Tel: 2707988372)

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Updated Business Mailing Address July 08, 2007

Registered at 650 JOEL DR, BLANCHFIELD ARMY COMMUNITY HOSPITAL, FT. CAMPBELL, KY 422235349 (Tel: 2707988372)

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Provider Name / Credentials Updated July 08, 2007

Recorded as JAY GORBAN, PHD

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Psychologist (License #718 in KY)

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Initial NPI Registration & Enumeration February 24, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1265408744
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 24, 2006
Last Update: July 08, 2007
Deactivation Date: March 01, 2021

Mailing Address

650 Joel Dr, Blanchfield Army Community Hospital

Ft. Campbell, KY 422235349

Phone: 2707988372

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

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