Organization Active NPI

Truecare Wellness, LLC

  • Clinical Psychologist
  • Roaring Spring, PA
National Provider Identifier
1952964413
Registry record updated Oct 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
TRUECARE WELLNESS, LLC
Doing business as
TrueCare Wellness, LLC
Practice address
7564 Woodbury Pike
Roaring Spring, PA 16673-1601
Phone
(814) 729-7316
Fax
(814) 729-7538
NPI assigned
Apr 19, 2019
Last updated
Oct 23, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2024

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

Authorized official

Name
Dr. Danielle Dively, PSY.D.NPI 1013155027
Title
Clinical Psychologist
Phone
(814) 285-7482

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU
Clinical Psychologist 103TC0700X NU Primary
Psychiatric/Mental Health Registered Nurse 163WP0808X NU

Addresses

Primary practice location

7564 Woodbury Pike
Roaring Spring, PA 16673-1601

Mailing address

390 Muley LN
New Enterprise, PA 16664-8306
Phone (814) 285-7482

Other identifiers 1

IdentifierTypeStateIssuer
1023128880003MedicaidPA

Other names 1

  • TrueCare Wellness, LLC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190920002682 PA Part B Supplier - Clinic/Group Practice 1850621673 Receives reassigned benefits from 2 practitioners
Practice locations: Roaring Spring, PA

National Provider Directory

National Provider Directory

Locations

7564 Woodbury Pike
Roaring Spring, PA 16673
Phone (814) 729-7316

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1555632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729641600000",
    "number": "1952964413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 MULEY LN",
            "city": "NEW ENTERPRISE",
            "state": "PA",
            "postal_code": "166648306",
            "telephone_number": "814-285-7482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7564 WOODBURY PIKE",
            "city": "ROARING SPRING",
            "state": "PA",
            "postal_code": "166731601",
            "telephone_number": "814-729-7316",
            "fax_number": "814-729-7538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRUECARE WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-19",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A",
        "authorized_official_last_name": "DIVELY",
        "authorized_official_first_name": "DANIELLE",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "814-285-7482",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1023128880003",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TrueCare Wellness, LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "TrueCare Wellness, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Roaring Spring, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.