Active NPI
Sophia A Mityagin, PHD
- Psychologist
- Columbus, OH
National Provider Identifier
1740325323
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 4196
- Practice address
- 1570 Fishinger Rd
Columbus, OH 43221 - Phone
- (614) 470-3095
- Fax
- (614) 451-4117
- NPI assigned
- Feb 21, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 4196 | OH | Primary |
Addresses
Primary practice location
1570 Fishinger Rd
Columbus, OH 43221
Mailing address
3538 La Rochelle Dr
Columbus, OH 43221
Phone (614) 470-3095
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
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172016000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1740325323",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3538 LA ROCHELLE DR",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "43221",
"telephone_number": "614-470-3095",
"fax_number": "614-451-4117"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1570 FISHINGER RD",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "43221",
"telephone_number": "614-470-3095",
"fax_number": "614-451-4117"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MITYAGIN",
"first_name": "SOPHIA",
"middle_name": "A",
"name_prefix": "Ms.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "OH",
"license": "4196",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbus, OH
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.