Individual provider Active NPI

Danielle Rynczak, PSYD

  • Forensic Psychologist
  • Worcester, MA
National Provider Identifier
1083234447
Registry record updated Apr 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Forensic PsychologistTaxonomy code 103TF0200X
License
11113 Issued in MA
Practice address
361 Plantation St
Worcester, MA 01605-2323
Phone
(774) 420-3131
Fax
(774) 420-3122
NPI assigned
Apr 25, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 11113 MA
Clinical Psychologist 103TC0700X 071008764 IL
Forensic Psychologist 103TF0200X 11113 MA Primary

Addresses

Primary practice location

361 Plantation St
Worcester, MA 01605-2323

Mailing address

8 Frongillo Farm Rd
Worcester, MA 01604-1777
Phone (217) 898-3347

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
071008764ILMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1587772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587772800000",
    "number": "1083234447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 FRONGILLO FARM RD",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016041777",
            "telephone_number": "217-898-3347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "361 PLANTATION ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016052323",
            "telephone_number": "774-420-3131",
            "fax_number": "774-420-3122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYNCZAK",
        "first_name": "DANIELLE",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-25",
        "last_updated": "2020-04-25",
        "certification_date": "2020-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "11113",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071008764",
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "MA",
            "license": "11113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.