Active NPI
Douglas David Moll, PSY.D.
- Psychologist
- Cincinnati, OH
National Provider Identifier
1093994428
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 6347
- Practice address
- 4968 Glenway Ave
2ND Floor
Cincinnati, OH 45238-3902 - Phone
- (513) 557-2810
- NPI assigned
- Nov 1, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 6347 | OH | Primary |
Addresses
Primary practice location
4968 Glenway Ave
2ND Floor
Cincinnati, OH 45238-3902
Mailing address
4968 Glenway Ave
2ND Floor
Cincinnati, OH 45238-3902
Phone (513) 557-2810
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6347 | OH | MD | Pain Medicine (Anesthesiology) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1193875200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193875200000",
"number": "1093994428",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4968 GLENWAY AVE",
"address_2": "2ND FLOOR",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452383902",
"telephone_number": "513-557-2810"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4968 GLENWAY AVE",
"address_2": "2ND FLOOR",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452383902",
"telephone_number": "513-557-2810"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOLL",
"first_name": "DOUGLAS",
"middle_name": "DAVID",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-11-01",
"last_updated": "2007-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "OH",
"license": "6347",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cincinnati, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.