Active NPI
Danielle Joi Sanchack, PSY.D
- Psychologist
- Jacksonville, FL
National Provider Identifier
1821080573
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 1336
- Practice address
- 11512 Lake Mead Ave Unit 704
Jacksonville, FL 32256-9682 - Phone
- (904) 616-5582
- NPI assigned
- Aug 18, 2005
- 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 | 1336 | AL | Primary |
Addresses
Primary practice location
11512 Lake Mead Ave Unit 704
Jacksonville, FL 32256-9682
Mailing address
2605 Cody Dr
Jacksonville, FL 32223-5585
Phone (904) 616-5582
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Oct 1, 2021 through Oct 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1336 | AL | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124323200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1487116800000",
"number": "1821080573",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2605 CODY DR",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322235585",
"telephone_number": "904-616-5582"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11512 LAKE MEAD AVE UNIT 704",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322569682",
"telephone_number": "904-616-5582"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANCHACK",
"first_name": "DANIELLE",
"middle_name": "JOI",
"name_prefix": "Dr.",
"credential": "PSY.D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-08-18",
"last_updated": "2017-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "AL",
"license": "1336",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.