Individual provider Active NPI

Alyssa Quenzel, PSY.D

  • Clinical Psychologist
  • Newark, DE
National Provider Identifier
1073192845
Registry record updated Apr 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
B1-0011264 Issued in DE
Practice address
300 Creek View Rd Ste 100
Newark, DE 19711-8546
Phone
(302) 307-3702
NPI assigned
Apr 7, 2021
Last updated
Apr 7, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X B1-0011264 DE Primary

Addresses

Primary practice location

300 Creek View Rd Ste 100
Newark, DE 19711-8546

Mailing address

35 Center St
Elmer, NJ 08318-2217
Phone (856) 275-1401

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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

Enrollment IDStateProvider typePAC IDDetails
I20220317002691 DE Practitioner - Clinical Psychologist 9335534957 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrative Psychology Group LLCGroup PAC ID 2466710439, 2 clinicians

Practice addresses (Care Compare)

300 Creek View Rd
Suite 101
Newark, DE 19711-8547
Phone 30230737020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Integrative Psychology Group LLC CurrentSince Jan 6, 2022 Accepting new patients

Locations

300 Creek View Rd
Ste 101
Newark, DE 19711
Phone (302) 307-3702

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1617753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617753600000",
    "number": "1073192845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 CENTER ST",
            "city": "ELMER",
            "state": "NJ",
            "postal_code": "083182217",
            "telephone_number": "856-275-1401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 CREEK VIEW RD STE 100",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197118546",
            "telephone_number": "302-307-3702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUENZEL",
        "first_name": "ALYSSA",
        "name_prefix": "Dr.",
        "credential": "PSY.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-07",
        "last_updated": "2021-04-07",
        "certification_date": "2021-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "DE",
            "license": "B1-0011264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

Verify at the official NPI Registry.