Dialectic Psychological Services, LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

4675 Issued in OH

Legal business name

DIALECTIC PSYCHOLOGICAL SERVICES, LLC

Practice address

1011 N Byrne Rd
Toledo, OH 43607-2710

Phone

(419) 788-7019

NPI assigned

Aug 26, 2013

Organization subpart

No

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

Authorized official

Name

David K Connell, PHDNPI 1750387577

Title

Owner

Phone

(419) 788-7019

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David K Connell, PH.D.

  • Clinical Psychologist
  • Toledo, OH
  • NPI 1750387577
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1377475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380240000000",
    "number": "1679907711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8440",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436230440",
            "telephone_number": "419-885-0200",
            "fax_number": "419-885-0203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 N BYRNE RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436072710",
            "telephone_number": "419-788-7019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIALECTIC PSYCHOLOGICAL SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-26",
        "last_updated": "2013-09-27",
        "status": "A",
        "authorized_official_last_name": "CONNELL",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "419-788-7019",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "4675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Toledo, OH
• Providers in Toledo, OH by specialty
• Clinical Psychologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.