Dara A Delancy, PSYD

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

PSY003096 Issued in GA

Practice address

3711 Executive Center Dr
Suite 101
Martinez, GA 30907-0951

Phone

(706) 210-8855

Fax

(678) 541-7699

NPI assigned

Aug 6, 2007

Last updated

Mar 21, 2013By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: georgiabehavioralhealthprofessionals.daradelancy@124220.advancedmd-direct.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Families Forward LLC

  • Clinical Child & Adolescent Psychologist
  • Martinez, GA
  • NPI 1962750869
  Authorized official Same address or phone
• Personal Recovery Network LLC

  dba LifeStance Health

  • Psychiatry Physician
  • Stockbridge, GA
  • NPI 1881990869
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1186358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363824000000",
    "number": "1821289877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3711 EXECUTIVE CENTER DR",
            "address_2": "SUITE 101",
            "city": "MARTINEZ",
            "state": "GA",
            "postal_code": "309070951",
            "telephone_number": "706-210-8855",
            "fax_number": "678-541-7699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3711 EXECUTIVE CENTER DR",
            "address_2": "SUITE 101",
            "city": "MARTINEZ",
            "state": "GA",
            "postal_code": "309070951",
            "telephone_number": "706-210-8855",
            "fax_number": "678-541-7699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELANCY",
        "first_name": "DARA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-06",
        "last_updated": "2013-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "GA",
            "license": "PSY003096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "447024026C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brianna Davis
• J Perry Davis, DMD
• Delton Wade De Vose, PHD, LPCS, CCS, BCTM
• Kimberly A Delaigle, FNP-C
• Lori Delaigle
• A'Niyah Delee
• Mary C Dement, MD
• Daelynn Dempsey
• Deborah K Dennis, CCC-SLP
• Jennifer Lee Deppen, ATC

• Clinical Child & Adolescent Psychologist in Martinez, GA
• Providers in Martinez, GA by specialty
• Clinical Child & Adolescent Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.