Derrick D'Artagnon Stahl, PSYD

Primary specialty

PsychologistTaxonomy code 103T00000X

Practice address

BLDG 14010
Carolinas Ave
Andersen AFB, GU 96929

Phone

(717) 880-1667

NPI assigned

Dec 20, 2023

Last updated

Dec 20, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1703030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703030400000",
    "number": "1992573802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 290262",
            "city": "YIGO",
            "state": "GU",
            "postal_code": "969293034",
            "telephone_number": "717-880-1667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BLDG 14010",
            "address_2": "CAROLINAS AVE",
            "city": "ANDERSEN AFB",
            "state": "GU",
            "postal_code": "96929",
            "telephone_number": "717-880-1667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAHL",
        "first_name": "DERRICK",
        "middle_name": "D'ARTAGNON",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-12-20",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Benjamin Huyck
• Imee Sarmiento Kiser, IDMT
• Scott Christopher Martin, O.D.
• Thaddeus Dwayne Mitcham, PHYSICIAN ASSISTANT
• Amanda Jo Solven, PA-C

• Psychologist in Andersen AFB, GU
• Providers in Andersen AFB, GU by specialty
• Psychologist in Guam

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2023; 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.