Dakota Mauzay, PY

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

61247046 Issued in WA

Practice address

1205 SE Professional Mall Blvd Ste 204
Pullman, WA 99163-5423

Phone

(509) 570-3302

NPI assigned

Dec 7, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Apr 1, 2024 through Apr 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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

• Storm Psychological Services

  • Clinical Psychologist
  • Pullman, WA
  • NPI 1275239949
  NPD Authorized official

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

{
    "created_epoch": "1638835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697414400000",
    "number": "1831857879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 SE PROFESSIONAL MALL BLVD STE 204",
            "city": "PULLMAN",
            "state": "WA",
            "postal_code": "991635423",
            "telephone_number": "509-570-3302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 SE PROFESSIONAL MALL BLVD STE 204",
            "city": "PULLMAN",
            "state": "WA",
            "postal_code": "991635423",
            "telephone_number": "509-570-3302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAUZAY",
        "first_name": "DAKOTA",
        "credential": "PY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-12-07",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "61247046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chyler Lynne Martinez
• Vanessa Lorraine Martinez, AFFILATED REGISTRATI
• Mary Parks DMD PLLC
• Denver Louise Mason
• Jennifer Lynn Mattoon, RPH
• Adrienne R Maxwell, RDN
• MC-Pull LLC
• Ash Faolan McConn
• Len D McCoy, PSY D
• Keira Reid McDonnell

• Clinical Psychologist in Pullman, WA
• Providers in Pullman, WA by specialty
• Clinical Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2023; 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.

Verify at the official NPI Registry.