Daniel Reed Mangine, PH.D.
Individual provider Active NPI Psychologist · Crafton, PA
NPI 1053590943 · NPPES record last updated Dec 28, 2016
Key facts
- NPI
- 1053590943
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychologist 103T00000X
- License
- PS016319 (PA)
- Practice address
- 39 White Ave
Crafton, PA 15205-2847 - Phone
- (412) 921-3050
- Fax
- (412) 922-3230
- NPI assigned
- Oct 29, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS016319 | PA | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Daniel R Mangine PHD LLC | Psychologist | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PS016319 | PA | Yes |
| Clinical Psychologist | 103TC0700X | PS016319 | PA |
Addresses
Primary practice location
39 White Ave
Crafton, PA 15205-2847
Mailing address
1553 Woodcrest Ave
Coraopolis, PA 15108-3064
Phone (412) 716-3047
Other providers in Crafton, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 28, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.