Active NPI
Maria Vonmickwitz, PHD
- Clinical Psychologist
- Latrobe, PA
National Provider Identifier
1659442580
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PS002632L
- Practice address
- 121 W Second Ave
Excela Latrobe Hospital
Latrobe, PA 15650-1068 - Phone
- (724) 537-1650
- Fax
- (724) 537-1918
- NPI assigned
- Nov 13, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- 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 | PS002632L | PA | Primary |
Addresses
Primary practice location
121 W Second Ave
Excela Latrobe Hospital
Latrobe, PA 15650-1068
Mailing address
121 W Second Ave
Excela Latrobe Hospital
Latrobe, PA 15650-1068
Phone (724) 537-1650
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)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS002632L | PA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163376000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1659442580",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "121 W SECOND AVE",
"address_2": "EXCELA LATROBE HOSPITAL",
"city": "LATROBE",
"state": "PA",
"postal_code": "156501068",
"telephone_number": "724-537-1650",
"fax_number": "724-537-1918"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "121 W SECOND AVE",
"address_2": "EXCELA LATROBE HOSPITAL",
"city": "LATROBE",
"state": "PA",
"postal_code": "156501068",
"telephone_number": "724-537-1650",
"fax_number": "724-537-1918"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VONMICKWITZ",
"first_name": "MARIA",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "PA",
"license": "PS002632L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.