Diane Menago, PSY.D. – Psychologist in Newtown, PA

Key facts

NPI: 1619204740
Entity type: Individual (NPI type 1)
Primary specialty: Psychologist 103T00000X
License: PS016705 (PA)
Practice address: 213 N Sycamore St
Newtown, PA 18940-1514
Phone: (215) 579-0302
Fax: (215) 579-0305
NPI assigned: Nov 10, 2009
Sex: Female
Sole proprietor: Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
PS016705	PA	MD	Psychologist

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Psychologist	103T00000X	PS016705	PA	Yes

Addresses

Primary practice location

213 N Sycamore St
Newtown, PA 18940-1514

Mailing address

213 N Sycamore St
Newtown, PA 18940-1514
Phone (215) 579-0302

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 10, 2009.

{
    "created_epoch": "1257811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257811200000",
    "number": "1619204740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 N SYCAMORE ST",
            "city": "NEWTOWN",
            "state": "PA",
            "postal_code": "189401514",
            "telephone_number": "215-579-0302",
            "fax_number": "215-579-0305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 N SYCAMORE ST",
            "city": "NEWTOWN",
            "state": "PA",
            "postal_code": "189401514",
            "telephone_number": "215-579-0302",
            "fax_number": "215-579-0305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENAGO",
        "first_name": "DIANE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-11-10",
        "last_updated": "2009-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PA",
            "license": "PS016705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newtown, PA

All providers in Newtown, PA · Psychologist in Pennsylvania

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 10, 2009. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.