Active NPI
Madeline I Maysonet, PSY.D
- Clinical Psychologist
- Lewisburg, PA
National Provider Identifier
1366626194
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PS017316
- Practice address
- 208 S 4TH St
Suite 4
Lewisburg, PA 17837-1865 - Phone
- (570) 939-2282
- NPI assigned
- Dec 28, 2007
- Last updated
- Aug 20, 2013
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 003332 | PR | |
| Clinical Psychologist | 103TC0700X | PS017316 | PA | Primary |
Addresses
Primary practice location
208 S 4TH St
Suite 4
Lewisburg, PA 17837-1865
Mailing address
208 S 4TH St
Suite 4
Lewisburg, PA 17837-1865
Phone (570) 939-2282
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 50115485 | Other | PA | CAPITAL BLUECROSS |
| 002798606 | Other | PA | BLUECROSS BLUESHIELD |
| 272764 | Other | PA | MEDICARE |
| 1027947040001 | Other | PA | DEPARTMENT OF PUBLIC WELFARE |
| 1366626194 | Other | PA | HUMANA |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 003332 | PR | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1198800000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1376956800000",
"number": "1366626194",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "208 S 4TH ST",
"address_2": "SUITE 4",
"city": "LEWISBURG",
"state": "PA",
"postal_code": "178371865",
"telephone_number": "570-939-2282"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "208 S 4TH ST",
"address_2": "SUITE 4",
"city": "LEWISBURG",
"state": "PA",
"postal_code": "178371865",
"telephone_number": "570-939-2282"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAYSONET",
"first_name": "MADELINE",
"middle_name": "I",
"name_prefix": "Dr.",
"credential": "PSY.D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-12-28",
"last_updated": "2013-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "PR",
"license": "003332",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "PA",
"license": "PS017316",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAPITAL BLUECROSS",
"identifier": "50115485",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSS BLUESHIELD",
"identifier": "002798606",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "272764",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPARTMENT OF PUBLIC WELFARE",
"identifier": "1027947040001",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HUMANA",
"identifier": "1366626194",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lewisburg, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.