Active NPI
Mary Ellen Sternitzke, PH.D.
- Clinical Psychologist
- Cheyenne, WY
National Provider Identifier
1871589317
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 267
- Practice address
- 821 W Pershing Blvd
Cheyenne, WY 82001-2537 - Phone
- (307) 638-4625
- Fax
- (307) 635-3965
- NPI assigned
- Sep 20, 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 267 | WY | Primary |
Addresses
Primary practice location
821 W Pershing Blvd
Cheyenne, WY 82001-2537
Mailing address
821 W Pershing Blvd
Cheyenne, WY 82001-2537
Phone (307) 638-4625
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 267 | WY | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127174400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1609200000000",
"number": "1871589317",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "821 W PERSHING BLVD",
"city": "CHEYENNE",
"state": "WY",
"postal_code": "820012537",
"telephone_number": "307-638-4625",
"fax_number": "307-635-3965"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "821 W PERSHING BLVD",
"city": "CHEYENNE",
"state": "WY",
"postal_code": "820012537",
"telephone_number": "307-638-4625",
"fax_number": "307-635-3965"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STERNITZKE",
"first_name": "MARY",
"middle_name": "ELLEN",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-09-20",
"last_updated": "2020-12-29",
"certification_date": "2020-12-29",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WY",
"license": "267",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cheyenne, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.