Organization Active NPI

Stephen W. Pearce, Psy.D., Inc.

  • Mental Health Counselor
  • Dayton, OH
National Provider Identifier
1124163514
Registry record updated Jun 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
STEPHEN W. PEARCE, PSY.D., INC.
Practice address
3821 Little York Rd
Dayton, OH 45414-2409
Phone
(937) 275-6510
Fax
(937) 264-1101
NPI assigned
Feb 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2012

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

Authorized official

Name
Dr. Stephen W Pearce, PSY.D.
Title
President
Phone
(937) 275-6510

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

3821 Little York Rd
Dayton, OH 45414-2409

Mailing address

3821 Little York Rd
Dayton, OH 45414-2409
Phone (937) 275-6510

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120626000128 OH Part B Supplier - Clinic/Group Practice 7517122542 Receives reassigned benefits from 1 practitioner
Practice locations: Dayton, OH

National Provider Directory

National Provider Directory

Locations

3821 Little York Rd
Dayton, OH 45414
Phone (937) 454-0092

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340582400000",
    "number": "1124163514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3821 LITTLE YORK RD",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454142409",
            "telephone_number": "937-275-6510",
            "fax_number": "937-264-1101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3821 LITTLE YORK RD",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454142409",
            "telephone_number": "937-275-6510",
            "fax_number": "937-264-1101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHEN W. PEARCE, PSY.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-21",
        "last_updated": "2012-06-25",
        "status": "A",
        "authorized_official_last_name": "PEARCE",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "937-275-6510",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.