Active NPI
Lisa Joan Diefenbach, PSY.D.
- Clinical Psychologist
- Indiana, PA
National Provider Identifier
1467471128
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PS015877
- Practice address
- 793 Old Route 119 Hwy N
Indiana, PA 15701-1372 - Phone
- (724) 465-5576
- Fax
- (724) 463-3262
- NPI assigned
- Jul 19, 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PS015877 | PA | Primary |
Addresses
Primary practice location
793 Old Route 119 Hwy N
Indiana, PA 15701-1372
Mailing address
793 Old Route 119 Hwy N
Indiana, PA 15701-1372
Phone (724) 465-5576
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 |
|---|---|---|---|
| PS015877 | PA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1467471128",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "793 OLD ROUTE 119 HWY N",
"city": "INDIANA",
"state": "PA",
"postal_code": "157011372",
"telephone_number": "724-465-5576",
"fax_number": "724-463-3262"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "793 OLD ROUTE 119 HWY N",
"city": "INDIANA",
"state": "PA",
"postal_code": "157011372",
"telephone_number": "724-465-5576",
"fax_number": "724-463-3262"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIEFENBACH",
"first_name": "LISA",
"middle_name": "JOAN",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-19",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "PA",
"license": "PS015877",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indiana, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.