Individual provider Active NPI

Samantha Joy Chu Yazvac, PSY.D.

  • Clinical Psychologist
  • Northampton, MA
National Provider Identifier
1508410937
Registry record updated Nov 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
10996 Issued in MA
Practice address
50 Pleasant St
Northampton, MA 01060-4127
Phone
(862) 432-6932
NPI assigned
Jul 24, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 10996 MA Primary

Addresses

Primary practice location

50 Pleasant St
Northampton, MA 01060-4127

Mailing address

4520 Stonegate Dr
Owensboro, KY 42303-9644
Phone (862) 432-6932

Other practice location 1

111 County Cir
Amherst, MA 01003-9255
Phone (413) 545-2337

Other practice location 2

75 Church St
Asheville, NC 28801-3623
Phone (828) 708-9955

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10996MAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Umass Health Services Amherst Past Accepting new patients
Asheville DBT & Trauma, PLLC PastSince Nov 24, 2024 Accepting new patients

Organizations & group practices 2

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": "1563926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732233600000",
    "number": "1508410937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4520 STONEGATE DR",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423039644",
            "telephone_number": "862-432-6932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 PLEASANT ST",
            "city": "NORTHAMPTON",
            "state": "MA",
            "postal_code": "010604127",
            "telephone_number": "862-432-6932"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 County Cir",
            "address_purpose": "LOCATION",
            "city": "Amherst",
            "state": "MA",
            "postal_code": "010039255",
            "country_code": "US",
            "telephone_number": "413-545-2337",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "75 Church St",
            "address_purpose": "LOCATION",
            "city": "Asheville",
            "state": "NC",
            "postal_code": "288013623",
            "country_code": "US",
            "telephone_number": "828-708-9955",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YAZVAC",
        "first_name": "SAMANTHA",
        "middle_name": "JOY CHU",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-24",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "10996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northampton, MA

Sources for this page

Verify at the official NPI Registry.