Active NPI
Teresa A. Key-Piciucco, PYSCH ASSISTANT
- Counselor
- Newark, OH
National Provider Identifier
1033279765
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 68 W Church St Ste 318
Newark, OH 43055-5050 - Phone
- (740) 281-1777
- Fax
- (740) 281-1778
- NPI assigned
- Dec 11, 2006
- Last updated
- Apr 29, 2025
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 1291 | WV | |
| Clinical Psychologist | 103TC0700X | 821 | WV | |
| Counselor | 101Y00000X | Primary |
Addresses
Primary practice location
68 W Church St Ste 318
Newark, OH 43055-5050
Mailing address
68 W Church St Ste 318
Newark, OH 43055-5050
Phone (740) 281-1777
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0005456001 | Medicaid | WV | |
| Y01291 | Other | WV | HEALTH PLAN ID |
| 001719061 | Other | WV | MSBCBS SERVICE ID |
| 588982000 | Other | WV | MAGELLAN MIS NUMBER |
| 2171255 | Other | WV | CIGNA ID NUMBER |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1291 | WV | MD | Clinical Child & Adolescent Psychologist |
| 821 | WV | MD | Rehabilitation Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1745884800000",
"number": "1033279765",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "68 W CHURCH ST STE 318",
"city": "NEWARK",
"state": "OH",
"postal_code": "430555050",
"telephone_number": "740-281-1777",
"fax_number": "740-281-1778"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "68 W CHURCH ST STE 318",
"city": "NEWARK",
"state": "OH",
"postal_code": "430555050",
"telephone_number": "740-281-1777",
"fax_number": "740-281-1778"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEY-PICIUCCO",
"first_name": "TERESA",
"middle_name": "A.",
"name_prefix": "Ms.",
"credential": "PYSCH ASSISTANT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-11",
"last_updated": "2025-04-29",
"certification_date": "2025-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "WV",
"license": "1291",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WV",
"license": "821",
"primary": false
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0005456001",
"state": "WV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PLAN ID",
"identifier": "Y01291",
"state": "WV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MSBCBS SERVICE ID",
"identifier": "001719061",
"state": "WV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAGELLAN MIS NUMBER",
"identifier": "588982000",
"state": "WV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA ID NUMBER",
"identifier": "2171255",
"state": "WV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Newark, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.