Individual provider Active NPI

Staci Direnzo

  • School Psychologist
  • Youngstown, OH
National Provider Identifier
1871917211
Registry record updated Feb 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
School PsychologistTaxonomy code 103TS0200X
License
OH1254217 Issued in OH
Practice address
100 Debartolo PL
Youngstown, OH 44512-7011
Phone
(330) 965-7828
NPI assigned
Feb 5, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Psychologist 103TS0200X OH1254217 OH Primary

Addresses

Primary practice location

100 Debartolo PL
Youngstown, OH 44512-7011

Mailing address

100 Debartolo PL
Youngstown, OH 44512-7011
Phone (330) 965-7828

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

LicenseStateTypeSpecialty
OH1254217OHMDSchool Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1391558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391558400000",
    "number": "1871917211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 DEBARTOLO PL",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445127011",
            "telephone_number": "330-965-7828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 DEBARTOLO PL",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445127011",
            "telephone_number": "330-965-7828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIRENZO",
        "first_name": "STACI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-05",
        "last_updated": "2014-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "OH",
            "license": "OH1254217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Youngstown, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.