Danielle L. Dively, PSY. D

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PS016634 Issued in PA

Practice address

7564 Woodbury Pike
Roaring Spring, PA 16673

Phone

(814) 729-7316

Fax

(814) 729-7538

NPI assigned

Jan 29, 2009

Last updated

Oct 23, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 8

Other names 1

• Danielle Leighty Former name

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Truecare Wellness, LLC

  • Clinical Psychologist
  • Roaring Spring, PA
  • NPI 1952964413
  Medicare reassignment NPD Authorized official
• Alternative Community Resource Program, Inc.

  • Community/Behavioral Health Agency
  • Everett, PA
  • NPI 1487173324
  NPD
• Pediatric Care Specialists

  • Multi-Specialty Clinic/Center
  • Johnstown, PA
  • NPI 1346236833
  NPD (past)
• Umas Family Resource Center

  • Psychiatry Physician
  • Windber, PA
  • NPI 1770141905
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1233187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1013155027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7564 WOODBURY PIKE (PO BOX 155)",
            "city": "ROARING SPRING",
            "state": "PA",
            "postal_code": "16673",
            "telephone_number": "814-729-7316",
            "fax_number": "814-729-7538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7564 WOODBURY PIKE",
            "city": "ROARING SPRING",
            "state": "PA",
            "postal_code": "16673",
            "telephone_number": "814-729-7316",
            "fax_number": "814-729-7538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIVELY",
        "first_name": "DANIELLE",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "PSY. D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-29",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PA",
            "license": "PS016634",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS016634PA",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS016634",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102312888",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNISON",
            "identifier": "000000285381",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007708200003",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1023128880002",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE CROSS BLUE SHIELD",
            "identifier": "002106964",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1023128880003",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "164856RGD",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1023128880004",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANIELLE",
            "last_name": "LEIGHTY",
            "credential": "PSY. D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Maria Nicole Dennis, PHYSICAL THERAPIST
• Steven L Diehl, M.D.
• Jessica Lynn Dilling, CRNP
• John Michael Dinger, M.D.
• Christina L Dively, DPT
• DLP Conemaugh Physician Practices LLC (CPP - Emergency Physicians - Meyersdale)
• Pauline C Dobson, PT
• Clay Walter Dodson, PT
• Steven Dodson, DMD
• Drayer Physical Therapy Institute LLC

• Clinical Psychologist in Roaring Spring, PA
• Providers in Roaring Spring, PA by specialty
• Clinical Psychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.