Individual provider Active NPI

Dee Nazzaro, PH.D

  • Psychologist
  • Wheeling, WV
National Provider Identifier
1497790794
Registry record updated Jul 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
WVE062385 Issued in WV
Practice address
2115 Chapline St
Suite 205
Wheeling, WV 26003-3859
Phone
(304) 280-5527
NPI assigned
Jun 19, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X WVE062385 WV Primary

Addresses

Primary practice location

2115 Chapline St
Suite 205
Wheeling, WV 26003-3859

Mailing address

2115 Chapline St
Suite 205
Wheeling, WV 26003-3859
Phone (304) 280-5527

Other identifiers 1

IdentifierTypeStateIssuer
3810002046MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20090507000205 WV Practitioner - Clinical Psychologist 0648354654 Practice locations: Wheeling, WV

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

76 -14TH St
Wheeling, WV 26003-3429
Phone (304) 280-5527

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
WVE062385WVMDPsychologist
1384WVMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Connolly, Ma, LPC, NCC, LLC PastSince Oct 29, 2023 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184544000000",
    "number": "1497790794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2115 CHAPLINE ST",
            "address_2": "SUITE 205",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "260033859",
            "telephone_number": "304-280-5527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 CHAPLINE ST",
            "address_2": "SUITE 205",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "260033859",
            "telephone_number": "304-280-5527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAZZARO",
        "first_name": "DEE",
        "name_prefix": "Dr.",
        "credential": "PH.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-19",
        "last_updated": "2007-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WV",
            "license": "WVE062385",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810002046",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheeling, WV

Sources for this page

Verify at the official NPI Registry.