Active NPI
Dolcelyn Zackrison, PSY.D.
- Clinical Psychologist
- Ringgold, GA
National Provider Identifier
1194862847
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(1) exclusion effective Jul 20, 2016.
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY002908
- Practice address
- 30 Hidden Trace Dr
Ringgold, GA 30736-2729 - Phone
- (706) 935-4700
- Fax
- (706) 935-4748
- NPI assigned
- Jan 31, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY002908 | GA | Primary |
Addresses
Primary practice location
30 Hidden Trace Dr
Ringgold, GA 30736-2729
Mailing address
30 Hidden Trace Dr
Ringgold, GA 30736-2729
Phone (706) 935-4700
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)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY002908 | GA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170201600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1194862847",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 HIDDEN TRACE DR",
"city": "RINGGOLD",
"state": "GA",
"postal_code": "307362729",
"telephone_number": "706-935-4700",
"fax_number": "706-935-4748"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 HIDDEN TRACE DR",
"city": "RINGGOLD",
"state": "GA",
"postal_code": "307362729",
"telephone_number": "706-935-4700",
"fax_number": "706-935-4748"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZACKRISON",
"first_name": "DOLCELYN",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "GA",
"license": "PSY002908",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ringgold, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.