Active NPI
Ashli Brooke Pellegrino, PHD
- Psychologist
- State College, PA
National Provider Identifier
1497010953
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PS018557
- Practice address
- 200 Scenery Dr
State College, PA 16801-7974 - Phone
- (814) 231-4560
- NPI assigned
- Jul 11, 2012
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | |||
| Psychologist | 103T00000X | PS018557 | PA | Primary |
Addresses
Primary practice location
200 Scenery Dr
State College, PA 16801-7974
Mailing address
100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 271-6144
Other practice location 1
65 Memorial Rd
West Hartford, CT 06107-2434
Phone (860) 696-2925
Other names 1
- Ashli Brooke Walters
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | awalters124771@direct.geisinger.edu | Direct |
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 |
|---|---|---|---|
| PS018557 | PA | MD | Psychologist |
Interoperability endpoints
- awalters124771@direct.geisinger.edu
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1341964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1598832000000",
"number": "1497010953",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 N ACADEMY AVE",
"city": "DANVILLE",
"state": "PA",
"postal_code": "178224903",
"telephone_number": "570-271-6144"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 SCENERY DR",
"city": "STATE COLLEGE",
"state": "PA",
"postal_code": "168017974",
"telephone_number": "814-231-4560"
}
],
"practiceLocations": [
{
"address_1": "65 Memorial Rd",
"address_purpose": "LOCATION",
"city": "West Hartford",
"state": "CT",
"postal_code": "061072434",
"country_code": "US",
"telephone_number": "860-696-2925",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PELLEGRINO",
"first_name": "ASHLI",
"middle_name": "BROOKE",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-07-11",
"last_updated": "2020-08-31",
"certification_date": "2020-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": null,
"license": null,
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "PA",
"license": "PS018557",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "awalters124771@direct.geisinger.edu",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "200 Scenery Dr",
"city": "State College",
"state": "PA",
"country_code": "US",
"postal_code": "168017974",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "ASHLI",
"last_name": "WALTERS",
"middle_name": "BROOKE",
"code": "1",
"type": "Former Name"
}
]
}Other providers in State College, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.