Active NPI
Stephen R Yerian, PSY D
- Clinical Psychologist
- Wpafb, OH
National Provider Identifier
1669460929
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 5440
- Practice address
- 4881 Sugar Maple Dr
Wpafb, OH 45433-5529 - Phone
- (937) 257-6877
- Fax
- (937) 656-1192
- NPI assigned
- Oct 11, 2005
- Sex
- Male
- 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 | 5440 | OH | Primary |
Addresses
Primary practice location
4881 Sugar Maple Dr
Wpafb, OH 45433-5529
Mailing address
1028 S Main St
Washington Court House, OH 43160-1958
Phone (740) 335-2720
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11585412 | Other | OH | CAQH |
| 367267 | Other | OH | MHN |
| 560694 | Other | OH | VALUEOPTIONS |
| 9398707 | Other | OH | PHCS |
| 000000374749 | Other | OH | ANTHEM |
| 310952952003 | Other | OH | HEALTHNET |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5440 | OH | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128988800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1523059200000",
"number": "1669460929",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1028 S MAIN ST",
"city": "WASHINGTON COURT HOUSE",
"state": "OH",
"postal_code": "431601958",
"telephone_number": "740-335-2720"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4881 SUGAR MAPLE DR",
"city": "WPAFB",
"state": "OH",
"postal_code": "454335529",
"telephone_number": "937-257-6877",
"fax_number": "937-656-1192"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YERIAN",
"first_name": "STEPHEN",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "PSY D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-11",
"last_updated": "2018-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "OH",
"license": "5440",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "11585412",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MHN",
"identifier": "367267",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUEOPTIONS",
"identifier": "560694",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHCS",
"identifier": "9398707",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000374749",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHNET",
"identifier": "310952952003",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wpafb, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 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.