Individual provider Active NPI

Nancy T. Dassoff, PH.D.

  • Clinical Psychologist
  • Colorado Springs, CO
National Provider Identifier
1093727430
Registry record updated Sep 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071004945 Issued in IL
Practice address
3625 Parkmoor Village Dr
Colorado Springs, CO 80917-5205
Phone
(888) 948-6789
Fax
(877) 345-3501
NPI assigned
Aug 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 071004945 IL
Clinical Psychologist 103TC0700X 071004945 IL Primary

Addresses

Primary practice location

3625 Parkmoor Village Dr
Colorado Springs, CO 80917-5205

Mailing address

4860 Robb St Ste 201
Wheat Ridge, CO 80033-2162
Phone (888) 948-6789

Other practice location 1

818 Harrison St
Oak Park, IL 60304-1144
Phone (773) 715-5425

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
071004945ILMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600128000000",
    "number": "1093727430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4860 ROBB ST STE 201",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800332162",
            "telephone_number": "888-948-6789",
            "fax_number": "877-345-3501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3625 PARKMOOR VILLAGE DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809175205",
            "telephone_number": "888-948-6789",
            "fax_number": "877-345-3501"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "818 Harrison St",
            "address_purpose": "LOCATION",
            "city": "Oak Park",
            "state": "IL",
            "postal_code": "603041144",
            "country_code": "US",
            "telephone_number": "773-715-5425",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DASSOFF",
        "first_name": "NANCY",
        "middle_name": "T.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-13",
        "last_updated": "2020-09-15",
        "certification_date": "2020-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "071004945",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071004945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 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.