Active NPI
Timothy Michael Digiacomo, PSY.D.
- Clinical Psychologist
- Hanover, NH
National Provider Identifier
1609144161
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1249
- Practice address
- 12 South St Ste 2a
Hanover, NH 03755-2163 - Phone
- (203) 913-3744
- NPI assigned
- Dec 12, 2011
- Sex
- Male
- 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 | 1249 | NH | Primary |
Addresses
Primary practice location
12 South St Ste 2a
Hanover, NH 03755-2163
Mailing address
12 South St Ste 2a
Hanover, NH 03755-2163
Phone (203) 913-3744
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 |
|---|---|---|---|
| 1249 | NH | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1323648000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1702512000000",
"number": "1609144161",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12 SOUTH ST STE 2A",
"city": "HANOVER",
"state": "NH",
"postal_code": "037552163",
"telephone_number": "203-913-3744"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12 SOUTH ST STE 2A",
"city": "HANOVER",
"state": "NH",
"postal_code": "037552163",
"telephone_number": "203-913-3744"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIGIACOMO",
"first_name": "TIMOTHY",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-12-12",
"last_updated": "2023-12-14",
"certification_date": "2023-12-14",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NH",
"license": "1249",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hanover, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.