Active NPI
Peter B Casgrain, PHD
- Clinical Psychologist
- Port Clinton, OH
National Provider Identifier
1386691731
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 4256
- Practice address
- 3872 E Harbor Light Landing Dr
Port Clinton, OH 43452-3877 - Phone
- (419) 734-3333
- Fax
- (419) 734-3335
- NPI assigned
- May 30, 2006
- Last updated
- Jul 16, 2018
- Sex
- Male
- 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 | 4256 | OH | Primary |
Addresses
Primary practice location
3872 E Harbor Light Landing Dr
Port Clinton, OH 43452-3877
Mailing address
3872 E Harbor Light Landing Dr
Port Clinton, OH 43452-3877
Phone (419) 734-3333
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 |
|---|---|---|---|
| 4256 | OH | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148947200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1531699200000",
"number": "1386691731",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3872 E HARBOR LIGHT LANDING DR",
"city": "PORT CLINTON",
"state": "OH",
"postal_code": "434523877",
"telephone_number": "419-734-3333",
"fax_number": "419-734-3335"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3872 E HARBOR LIGHT LANDING DR",
"city": "PORT CLINTON",
"state": "OH",
"postal_code": "434523877",
"telephone_number": "419-734-3333",
"fax_number": "419-734-3335"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CASGRAIN",
"first_name": "PETER",
"middle_name": "B",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-30",
"last_updated": "2018-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "OH",
"license": "4256",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Clinton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.