Athena Dacanay, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071.009576 Issued in IL

Practice address

808 S Eldorado Rd Ste 102
Bloomington, IL 61704-6075

Phone

(309) 706-3190

Fax

(309) 706-3190

NPI assigned

Jul 11, 2017

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

Enrolled in NC

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

Specialty

Clinical Psychologist

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lifestancehealth.athenadacanay@146897.advancedmd-direct.com

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.

• Cotswold Clinician Support Services

  • Community/Behavioral Health Agency
  • Charlotte, NC
  • NPI 1063893568
  Medicare reassignment NPD
• People & Paws Psychological Services, PLLC

  • Psychologist
  • Asheville, NC
  • NPI 1073377669
  Medicare reassignment NPD

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

{
    "created_epoch": "1499731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499731200000",
    "number": "1255853396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 604",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617020604",
            "telephone_number": "309-706-3190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 S ELDORADO RD STE 102",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617046075",
            "telephone_number": "309-706-3190",
            "fax_number": "309-706-3190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DACANAY",
        "first_name": "ATHENA",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-11",
        "last_updated": "2017-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.009576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cynthia M Harbaugh, LLC
• Cynthia M Harbaugh, LLC
• Rhianna Cyr
• Anna M Czipri, PSY.D.
• D B Medical Supplies Inc
• Patrick Dagg
• Cynthia Daggy, PHARMD
• Ashley R. Dagner, MS, LCPC
• Victoria Lynch Dahmm, MS, LCPC
• Hosannah Marie Dalogdog, PHARMD

• Clinical Psychologist in Bloomington, IL
• Providers in Bloomington, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.