Active NPI
Stella Petronda, PSY.D
- Clinical Psychologist
- Stockbridge, MA
National Provider Identifier
1811223134
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 9017
- Practice address
- 25 Main Street
Suite 208
Stockbridge, MA 01262 - Phone
- (413) 931-5214
- NPI assigned
- Oct 21, 2009
- Last updated
- Oct 21, 2009
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 9017 | MA | Primary |
Addresses
Primary practice location
25 Main Street
Suite 208
Stockbridge, MA 01262
Mailing address
1112 North St Apt 1
Pittsfield, MA 01201-1557
Phone (413) 553-3165
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 |
|---|---|---|---|
| 9017 | MA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1256083200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1256083200000",
"number": "1811223134",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1112 NORTH ST APT 1",
"city": "PITTSFIELD",
"state": "MA",
"postal_code": "012011557",
"telephone_number": "413-553-3165"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25 MAIN STREET",
"address_2": "SUITE 208",
"city": "STOCKBRIDGE",
"state": "MA",
"postal_code": "01262",
"telephone_number": "413-931-5214"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETRONDA",
"first_name": "STELLA",
"name_prefix": "Dr.",
"credential": "PSY.D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-10-21",
"last_updated": "2009-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MA",
"license": "9017",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stockbridge, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.