Individual provider Active NPI

Marybeth Angilella Dartley, PHD

  • Psychologist
  • New York, NY
National Provider Identifier
1215238274
Registry record updated Dec 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
018009-1 Issued in NY
Practice address
30 E 20TH St Ste 5RW
New York, NY 10003-1310
Phone
(917) 696-7080
NPI assigned
Nov 8, 2010
Last updated
Dec 30, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 018009-1 NY Primary
Counseling Psychologist 103TC1900X TE61249834 WA

Addresses

Primary practice location

30 E 20TH St Ste 5RW
New York, NY 10003-1310

Mailing address

32 Gramercy Park S
10D
New York, NY 10003-1707
Phone (212) 420-9691

Other practice location 1

928 Broadway Ste 1100
New York, NY 10010-8115
Phone (917) 696-7080

Other names 1

  • Dr. Marybeth Angilella Former name

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
TE61249834WAMDCounseling Psychologist
018009-1NYMDSurgical Physician Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1289174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640822400000",
    "number": "1215238274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 GRAMERCY PARK S",
            "address_2": "10D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100031707",
            "telephone_number": "212-420-9691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 E 20TH ST STE 5RW",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100031310",
            "telephone_number": "917-696-7080"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "928 Broadway Ste 1100",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100108115",
            "country_code": "US",
            "telephone_number": "917-696-7080",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANGILELLA DARTLEY",
        "first_name": "MARYBETH",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-08",
        "last_updated": "2021-12-30",
        "certification_date": "2021-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "018009-1",
            "primary": true
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "WA",
            "license": "TE61249834",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARYBETH",
            "last_name": "ANGILELLA",
            "prefix": "DR.",
            "credential": "PHD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 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.