Active NPI
Janice Irene Mautz, PSY.D.
- Clinical Psychologist
- Dayton, OH
National Provider Identifier
1770795148
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 3813
- Practice address
- 3095 Kettering Blvd
Dayton, OH 45439-1921 - Phone
- (937) 643-7097
- NPI assigned
- May 5, 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 3813 | OH | Primary |
Addresses
Primary practice location
3095 Kettering Blvd
Dayton, OH 45439-1921
Mailing address
1425 Old Lane Ave
Apt. 3
Kettering, OH 45409-1729
Phone (937) 395-9711
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3813 | OH | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178323200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1350864000000",
"number": "1770795148",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1425 OLD LANE AVE",
"address_2": "APT. 3",
"city": "KETTERING",
"state": "OH",
"postal_code": "454091729",
"telephone_number": "937-395-9711"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3095 KETTERING BLVD",
"city": "DAYTON",
"state": "OH",
"postal_code": "454391921",
"telephone_number": "937-643-7097"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAUTZ",
"first_name": "JANICE",
"middle_name": "IRENE",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-05",
"last_updated": "2012-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "OH",
"license": "3813",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dayton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.