Individual provider Active NPI

Trey Victor Dellucci, PHD

  • Clinical Psychologist
  • Indianapolis, IN
National Provider Identifier
1639759350
Registry record updated Feb 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
20043873B Issued in IN
Practice address
1002 Wishard Blvd Ste 1100
Indianapolis, IN 46202-4164
Phone
(317) 274-8812
Fax
(317) 274-0133
NPI assigned
Apr 8, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 20043873B IN Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1002 Wishard Blvd Ste 1100
Indianapolis, IN 46202-4164

Mailing address

PO Box 719094
Chicago, IL 60677-9318
Phone (317) 777-6435

Other practice location 1

One Park Avenue
7th Floor
New York, NY 10016
Phone (225) 636-0833

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20250620001867 IN Practitioner - Clinical Psychologist 4183136757 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University Pediatric Associates, Inc. CurrentSince Jun 12, 2025 Accepting new patients
Iu Health Medical Group Riley Specialists, LLC Past Accepting new patients

Locations

705 Riley Hospital Dr
Indianapolis, IN 46202
Phone (317) 274-4779

1002 Wishard Blvd
Ste 1100
Indianapolis, IN 46202
Phone (317) 274-8812

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": "1617840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770940800000",
    "number": "1639759350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 719094",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606779318",
            "telephone_number": "317-777-6435",
            "fax_number": "317-777-6644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 WISHARD BLVD STE 1100",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462024164",
            "telephone_number": "317-274-8812",
            "fax_number": "317-274-0133"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "One Park Avenue",
            "address_2": "7th Floor",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "10016",
            "country_code": "US",
            "telephone_number": "225-636-0833",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DELLUCCI",
        "first_name": "TREY",
        "middle_name": "VICTOR",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-08",
        "last_updated": "2026-02-13",
        "certification_date": "2026-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20043873B",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.