Paul J Divincenzo PH.D

Primary specialty

PsychologistTaxonomy code 103T00000X

License

3923 Issued in OH

Legal business name

PAUL J DIVINCENZO PH.D

Practice address

5311 Northfield Rd
Bedford HTS, OH 44146-1135

Phone

(216) 518-3900

NPI assigned

Jan 7, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Paul John DivincenzoNPI 1386740439

Title

President

Phone

(216) 518-3900

Specialties & licenses 1

Addresses

Other identifiers 13

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Paul John Divincenzo, PH.D

  • Psychologist
  • Bedford HTS, OH
  • NPI 1386740439
  NPD (past) Authorized official

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

{
    "created_epoch": "1168128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1942358148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5311 NORTHFIELD RD",
            "city": "BEDFORD HTS",
            "state": "OH",
            "postal_code": "441461135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5311 NORTHFIELD RD",
            "city": "BEDFORD HTS",
            "state": "OH",
            "postal_code": "441461135",
            "telephone_number": "216-518-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL J DIVINCENZO PH.D",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DIVINCENZO",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "216-518-3900",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "OH",
            "license": "3923",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "3923",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000141048",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0443756",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER",
            "identifier": "3923",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMERALD HEALTH",
            "identifier": "3923",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4073101",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRI CARE",
            "identifier": "3923",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTION",
            "identifier": "3923",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL MUTUAL",
            "identifier": "288460455007",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MBHS",
            "identifier": "3923",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMPSYCH",
            "identifier": "3923",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "3923",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED BEHAVIORAL HEALTH",
            "identifier": "3923",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Bedford HTS, OH
• Providers in Bedford HTS, OH by specialty
• Psychologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.

Verify at the official NPI Registry.