Active NPI
Deborah Fetter Nastasi, PH.D.
- School Psychologist
- Diberville, MS
National Provider Identifier
1730478306
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 36-635
- Practice address
- 4061 Suzanne Dr
Diberville, MS 39540-3735 - Phone
- (228) 396-4434
- NPI assigned
- Apr 4, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 36-635 | MS | Primary |
Addresses
Primary practice location
4061 Suzanne Dr
Diberville, MS 39540-3735
Mailing address
4061 Suzanne Dr
Diberville, MS 39540-3735
Phone (228) 396-4434
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 |
|---|---|---|---|
| 36-635 | MS | MD | School Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1301875200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1301875200000",
"number": "1730478306",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4061 SUZANNE DR",
"city": "DIBERVILLE",
"state": "MS",
"postal_code": "395403735",
"telephone_number": "228-396-4434"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4061 SUZANNE DR",
"city": "DIBERVILLE",
"state": "MS",
"postal_code": "395403735",
"telephone_number": "228-396-4434"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NASTASI",
"first_name": "DEBORAH",
"middle_name": "FETTER",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-04-04",
"last_updated": "2011-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "MS",
"license": "36-635",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Diberville, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.