Individual provider Active NPI

Sara Nicole Sayre, PH.D.

  • Counseling Psychologist
  • Canton, OH
National Provider Identifier
1174005706
Registry record updated Mar 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
P.07773 Issued in OH
Practice address
4319 Hills and Dales Rd NW
Canton, OH 44708-1663
Phone
(330) 492-2006
Fax
(330) 492-2161
NPI assigned
Aug 30, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X P.07773 OH Primary

Addresses

Primary practice location

4319 Hills and Dales Rd NW
Canton, OH 44708-1663

Mailing address

4319 Hills and Dales Rd NW
Canton, OH 44708-1663
Phone (330) 492-2006

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190124000390 OH Practitioner - Clinical Psychologist 1355688623 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Barbara Fordyce and Associates, LLCGroup PAC ID 4486966538, 4 clinicians

Practice addresses (Care Compare)

4319 Hills and Dales Rd NW
Canton, OH 44708-1663
Phone (330) 492-2006

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1535587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552953600000",
    "number": "1174005706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4319 HILLS AND DALES RD NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447081663",
            "telephone_number": "330-492-2006",
            "fax_number": "330-492-2161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4319 HILLS AND DALES RD NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447081663",
            "telephone_number": "330-492-2006",
            "fax_number": "330-492-2161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAYRE",
        "first_name": "SARA",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-30",
        "last_updated": "2019-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "OH",
            "license": "P.07773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

Verify at the official NPI Registry.