Individual provider Active NPI

Robert Edward Daufenbach, PHD

  • Mental Health Counselor
  • West Mifflin, PA
National Provider Identifier
1407955271
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
PC003875 Issued in PA
Practice address
500 N Lewis Run Rd Ste 129
West Mifflin, PA 15122-3058
Phone
(412) 469-8220
Fax
(412) 469-9365
NPI assigned
Sep 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X PC003875 PA Primary

Addresses

Primary practice location

500 N Lewis Run Rd Ste 129
West Mifflin, PA 15122-3058

Mailing address

500 N Lewis Run Rd Ste 129
West Mifflin, PA 15122-3058
Phone (412) 469-8220

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
PC003875PAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Jack Mannheimer MD PC Mental Health PastSince Nov 27, 1995 Accepting new patients
Jack Mannheimer M.D. PC Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407955271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 N LEWIS RUN RD STE 129",
            "city": "WEST MIFFLIN",
            "state": "PA",
            "postal_code": "151223058",
            "telephone_number": "412-469-8220",
            "fax_number": "412-469-9365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N LEWIS RUN RD STE 129",
            "city": "WEST MIFFLIN",
            "state": "PA",
            "postal_code": "151223058",
            "telephone_number": "412-469-8220",
            "fax_number": "412-469-9365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAUFENBACH",
        "first_name": "ROBERT",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "PA",
            "license": "PC003875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Mifflin, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.