Lise Deguire, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

35S100298400 Issued in NJ

Practice address

114 Straube Center Blvd
Building K; Suite 1-7
Pennington, NJ 08534-1450

Phone

(609) 737-7795

NPI assigned

Aug 30, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Oct 1, 2021 through Oct 1, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710097662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 STRAUBE CENTER BLVD",
            "address_2": "BUILDING K; SUITE 1-7",
            "city": "PENNINGTON",
            "state": "NJ",
            "postal_code": "085341450",
            "telephone_number": "609-737-7795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 STRAUBE CENTER BLVD",
            "address_2": "BUILDING K; SUITE 1-7",
            "city": "PENNINGTON",
            "state": "NJ",
            "postal_code": "085341450",
            "telephone_number": "609-737-7795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEGUIRE",
        "first_name": "LISE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "35S100298400",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS006103L",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Anthony De Santis, M.D.
• Brianna Marie Deblois, PA
• Donald J Debrakeleer, DO
• Amanda Decker, CRNP, PMHNP
• Yoganand Deendyal, MD
• Stacey Ann Delaney, APN, CRNA
• Joseph Michael Dellacroce, MD
• Carla Marie Delre, LPC
• Johanna B. Demirjian, NP
• Yingzi Deng, M.D., M.S

• Clinical Psychologist in Pennington, NJ
• Providers in Pennington, NJ by specialty
• Clinical Psychologist in New Jersey

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.