Active NPI
Daniella Cavenagh, PHD
- Clinical Psychologist
- Wayne, PA
National Provider Identifier
1366471484
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PS016868
- Practice address
- 1265 Drummers LN Ste 120
Wayne, PA 19087-1570 - Phone
- (215) 258-4191
- NPI assigned
- Jul 1, 2006
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY18504 | CA | |
| Clinical Psychologist | 103TC0700X | LP4910 | MN | |
| Clinical Psychologist | 103TC0700X | PS016868 | PA | Primary |
Addresses
Primary practice location
1265 Drummers LN Ste 120
Wayne, PA 19087-1570
Mailing address
PO Box 144
Flourtown, PA 19031-0144
Phone (215) 258-4191
Organizations & group practices 2
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.
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY18504 | CA | MD | Clinical Psychologist |
| LP4910 | MN | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| LMF Psychological Services LLC | Clinical | Past | Accepting new patients |
| Lynne J Freeman PSYD PC | Clinical | Past | Accepting new patients |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151712000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692057600000",
"number": "1366471484",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 144",
"city": "FLOURTOWN",
"state": "PA",
"postal_code": "190310144",
"telephone_number": "215-258-4191"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1265 DRUMMERS LN STE 120",
"city": "WAYNE",
"state": "PA",
"postal_code": "190871570",
"telephone_number": "215-258-4191"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAVENAGH",
"first_name": "DANIELLA",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-01",
"last_updated": "2023-08-15",
"certification_date": "2023-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY18504",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MN",
"license": "LP4910",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "PA",
"license": "PS016868",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wayne, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.