Individual provider Active NPI

Gina Christine Lafrazza, PSY.D.

  • Psychologist
  • State College, PA
National Provider Identifier
1619226883
Registry record updated Apr 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
4342 Issued in NC
Practice address
320 Rolling Ridge Dr
State College, PA 16801-7641
Phone
(814) 867-0670
NPI assigned
Sep 4, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 4342 NC Primary

Addresses

Primary practice location

320 Rolling Ridge Dr
State College, PA 16801-7641

Mailing address

320 Rolling Ridge Dr
State College, PA 16801-7641
Phone (850) 445-3662

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

LicenseStateTypeSpecialty
4342NCMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1346716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522627200000",
    "number": "1619226883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 ROLLING RIDGE DR",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168017641",
            "telephone_number": "850-445-3662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 ROLLING RIDGE DR",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168017641",
            "telephone_number": "814-867-0670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAFRAZZA",
        "first_name": "GINA",
        "middle_name": "CHRISTINE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-04",
        "last_updated": "2018-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NC",
            "license": "4342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Apr 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.