Laura Dieckhoff, SCHOOL PSYCHOLOGIST

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

6 Bridle Path LN
Port Jefferson, NY 11777-1514

Phone

(516) 233-6965

NPI assigned

Aug 17, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1629158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629158400000",
    "number": "1134895493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 BRIDLE PATH LN",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117771514",
            "telephone_number": "516-233-6965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 BRIDLE PATH LN",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117771514",
            "telephone_number": "516-233-6965"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "90 Adams Ave # 110",
            "address_purpose": "LOCATION",
            "city": "Hauppauge",
            "state": "NY",
            "postal_code": "117883631",
            "country_code": "US",
            "telephone_number": "631-952-3333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIECKHOFF",
        "first_name": "LAURA",
        "name_prefix": "Mrs.",
        "credential": "SCHOOL PSYCHOLOGIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-17",
        "last_updated": "2021-08-17",
        "certification_date": "2021-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nitasha Dhiman
• Janet Dibartolo
• Mark J Dibenedetto, M.D.
• Doreen Dibiase, LCSW-R
• Loretta Didwell
• Chijioke Dike, MD
• Jomar Dimanlig, PT, CLT-LANA
• Kristen Dismore, PA
• Denise Dixon, PH.D.
• Patricia Dodd, N.P.

• Student in an Organized Health Care Education/Training Program in Port Jefferson, NY
• Providers in Port Jefferson, NY by specialty
• Student in an Organized Health Care Education/Training Program in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2021; 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.