Individual provider Active NPI

Daniel Lee Phalen, PHD

  • Psychologist
  • Columbus, OH
National Provider Identifier
1982872776
Registry record updated Feb 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
2720 Issued in OH
Practice address
1015 E Broad St Ste 105
Columbus, OH 43205-1378
Phone
(614) 372-5535
Fax
(614) 372-5536
NPI assigned
Feb 14, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 2720 OH Primary

Addresses

Primary practice location

1015 E Broad St Ste 105
Columbus, OH 43205-1378

Mailing address

1015 E Broad St Ste 105
Columbus, OH 43205-1378
Phone (614) 372-5535

Other identifiers 1

IdentifierTypeStateIssuer
0384114MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041123000061 OH Practitioner - Clinical Psychologist 1052376712 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1015 E Broad St
Suite 105
Columbus, OH 43205-1378
Phone (614) 372-5535

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
2720OHMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Daniel L Phalen PHD Inc Psychologist CurrentSince Dec 9, 2005 Accepting new patients

Locations

1015 E Broad St
Ste 105
Columbus, OH 43205
Phone (614) 372-5535

181 Granville St
Ste G
Gahanna, OH 43230
Phone (614) 475-7462

348 Granville St
Ste B
Gahanna, OH 43230
Phone (614) 475-7462

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1202947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707350400000",
    "number": "1982872776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 E BROAD ST STE 105",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432051378",
            "telephone_number": "614-372-5535",
            "fax_number": "614-372-5535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 E BROAD ST STE 105",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432051378",
            "telephone_number": "614-372-5535",
            "fax_number": "614-372-5536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHALEN",
        "first_name": "DANIEL",
        "middle_name": "LEE",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-14",
        "last_updated": "2024-02-08",
        "certification_date": "2024-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OH",
            "license": "2720",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0384114",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.