Individual provider Active NPI

Joseph P Decola, PHD

  • Clinical Psychologist
  • Worthington, OH
National Provider Identifier
1669436291
Registry record updated Dec 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
5678 Issued in OH
Practice address
6797 N High St
Suite 214
Worthington, OH 43085-2533
Phone
(614) 407-5776
Fax
(614) 436-4830
NPI assigned
Apr 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 5678 OH Primary

Addresses

Primary practice location

6797 N High St
Suite 214
Worthington, OH 43085-2533

Mailing address

6797 N High St
Suite 214
Worthington, OH 43085-2533
Phone (614) 407-5776

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20040310000007 OH Practitioner - Clinical Psychologist 1557259744

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5678OHMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Beth T. McCreary, PHD, LLC Clinical CurrentSince Jun 1, 2016 Accepting new patients

Locations

6797 N High St
Ste 214
Worthington, OH 43085
Phone (614) 407-5776

659 High St
Ste 202
Worthington, OH 43085
Phone (614) 436-5030

Organizations & group practices 1

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": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480550400000",
    "number": "1669436291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6797 N HIGH ST",
            "address_2": "SUITE 214",
            "city": "WORTHINGTON",
            "state": "OH",
            "postal_code": "430852533",
            "telephone_number": "614-407-5776",
            "fax_number": "614-436-4830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6797 N HIGH ST",
            "address_2": "SUITE 214",
            "city": "WORTHINGTON",
            "state": "OH",
            "postal_code": "430852533",
            "telephone_number": "614-407-5776",
            "fax_number": "614-436-4830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECOLA",
        "first_name": "JOSEPH",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-12",
        "last_updated": "2016-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "5678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worthington, OH

Sources for this page

Verify at the official NPI Registry.