Individual provider Active NPI

David Victor Mandich, PSYD

  • Psychologist
  • Cincinnati, OH
National Provider Identifier
1073028783
Registry record updated Aug 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
P.08780 Issued in OH
Practice address
3333 Burnet Ave
ML 3015
Cincinnati, OH 45229-3026
Phone
(513) 636-4336
Fax
(513) 636-7756
NPI assigned
Dec 5, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X P.08780 OH Primary

Addresses

Primary practice location

3333 Burnet Ave
ML 3015
Cincinnati, OH 45229-3026

Mailing address

3333 Burnet Ave
ML 5021
Cincinnati, OH 45229-3039
Phone (513) 636-4225

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, OH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190531000606 WV Practitioner - Clinical Psychologist 6204169527 Reassigns benefits to 1 organization
I20250905000102 OH Practitioner - Clinical Psychologist 6204169527 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3333 Burnet Ave
Cincinnati, OH 45229-3039

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P.08780OHMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Cabin Creek Health Center, Inc. CurrentSince Apr 26, 2019 Accepting new patients
Children'S Hospital Medical Center Psychologist CurrentSince Aug 14, 2025 Accepting new patients
Cabin Creek Health Center, Inc. CurrentSince Apr 26, 2019 Accepting new patients

Locations

3341 Solutions Ctr
Chicago, IL 60677

3333 Burnet Ave
Cincinnati, OH 45229
Phone (513) 636-4200

3333 Burnet Ave
#5021
Cincinnati, OH 45229
Phone (513) 636-4225

3333 Burnet Ave
#3015
Cincinnati, OH 45229
Phone (513) 636-4336

1 Warrior Way
Ste 103
Belle, WV 25015
Phone (304) 949-3591

104 Alex Ln
Charleston, WV 25304
Phone 30473420401319

4602 Maccorkle Ave SE
Charleston, WV 25304
Phone (304) 205-7535

107 Koontz Ave
Ste 200
Clendenin, WV 25045
Phone (304) 548-7272

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1512432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755993600000",
    "number": "1073028783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 BURNET AVE",
            "address_2": "ML 5021",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452293039",
            "telephone_number": "513-636-4225",
            "fax_number": "513-636-2511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 BURNET AVE",
            "address_2": "ML 3015",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452293026",
            "telephone_number": "513-636-4336",
            "fax_number": "513-636-7756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDICH",
        "first_name": "DAVID",
        "middle_name": "VICTOR",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-12-05",
        "last_updated": "2025-08-24",
        "certification_date": "2025-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OH",
            "license": "P.08780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.