Active NPI
Mary Iampietro, PH.D.
- Clinical Child & Adolescent Psychologist
- Wilmington, DE
National Provider Identifier
1003211277
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Child & Adolescent Psychologist
- License
- PS018565
- Practice address
- 1600 Rockland Rd
Wilmington, DE 19803-3607 - Phone
- (302) 651-4200
- NPI assigned
- Oct 29, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Child & Adolescent Psychologist | 103TC2200X | 35SI00570900 | NJ | |
| Clinical Child & Adolescent Psychologist | 103TC2200X | B10001073 | DE | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Clinical Child & Adolescent Psychologist | 103TC2200X | PS018565 | PA | Primary |
Addresses
Primary practice location
1600 Rockland Rd
Wilmington, DE 19803-3607
Mailing address
3401 Civic Center Blvd
Philadelphia, PA 19104-4319
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 |
|---|---|---|---|
| B10001073 | DE | MD | Clinical Child & Adolescent Psychologist |
| 35SI00570900 | NJ | MD | Clinical Child & Adolescent Psychologist |
| PS018565 | PA | MD | Clinical Child & Adolescent Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1414540800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1541462400000",
"number": "1003211277",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3401 CIVIC CENTER BLVD",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191044319"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1600 ROCKLAND RD",
"city": "WILMINGTON",
"state": "DE",
"postal_code": "198033607",
"telephone_number": "302-651-4200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IAMPIETRO",
"first_name": "MARY",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-10-29",
"last_updated": "2018-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "NJ",
"license": "35SI00570900",
"primary": false
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "DE",
"license": "B10001073",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "PA",
"license": "PS018565",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Wilmington, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.