Individual provider Active NPI

Jonathan D Lichtenstein, PSYD

  • Psychologist
  • Lebanon, NH
National Provider Identifier
1427465590
Registry record updated Apr 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
1320 Issued in NH
Practice address
1 Medical Center Dr
Dartmouth Hitchcock - Psychology
Lebanon, NH 03756-1000
Phone
(603) 650-6150
NPI assigned
Jul 21, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 1320 NH Primary

Addresses

Primary practice location

1 Medical Center Dr
Dartmouth Hitchcock - Psychology
Lebanon, NH 03756-1000

Mailing address

1 Medical Center Dr
Dartmouth Hitchcock - Psychology
Lebanon, NH 03756-1000
Phone (603) 650-6150

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140905000868 NH Practitioner - Clinical Psychologist 7911125836 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dartmouth-Hitchcock Clinic CurrentSince Jul 1, 2016 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Jul 1, 2016 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Jul 1, 2016 Accepting new patients

Locations

1 Medical Dr
Lebanon, NH 03756
Phone (603) 650-5922

Organizations & group practices 3

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": "1405900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491436800000",
    "number": "1427465590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "address_2": "DARTMOUTH HITCHCOCK - PSYCHOLOGY",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037561000",
            "telephone_number": "603-650-6150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "address_2": "DARTMOUTH HITCHCOCK - PSYCHOLOGY",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037561000",
            "telephone_number": "603-650-6150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LICHTENSTEIN",
        "first_name": "JONATHAN",
        "middle_name": "D",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-21",
        "last_updated": "2017-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NH",
            "license": "1320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, NH

Sources for this page

Verify at the official NPI Registry.