Active NPI
Lynn R. Dimarzio, PHD
- Psychologist
- Boardman, OH
National Provider Identifier
1417961459
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 4226
- Practice address
- 8170 South Ave
Suite 1
Boardman, OH 44512 - Phone
- (330) 726-2965
- Fax
- (330) 726-0449
- NPI assigned
- Jul 27, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 4226 | OH | Primary |
Addresses
Primary practice location
8170 South Ave
Suite 1
Boardman, OH 44512
Mailing address
831 Southwestern Run Ste 2
Poland, OH 44514-3694
Phone (330) 726-2965
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0768147 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1987
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
831 Southwestern Run
Suite 2
Youngstown, OH 44514-3694
Phone (330) 726-2965
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4226 | OH | MD | Psychologist |
Organizations & group practices 1
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.
-
- Psychologist
- Poland, OH
- NPI 1215116264
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724025600000",
"number": "1417961459",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "831 SOUTHWESTERN RUN STE 2",
"city": "POLAND",
"state": "OH",
"postal_code": "445143694",
"telephone_number": "330-726-2965",
"fax_number": "330-726-0449"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8170 SOUTH AVE",
"address_2": "SUITE 1",
"city": "BOARDMAN",
"state": "OH",
"postal_code": "44512",
"telephone_number": "330-726-2965",
"fax_number": "330-726-0449"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIMARZIO",
"first_name": "LYNN",
"middle_name": "R.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-27",
"last_updated": "2024-08-19",
"certification_date": "2024-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "OH",
"license": "4226",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0768147",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Boardman, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2024; 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.