Derrick D'Artagnon Stahl, PSYD
Individual provider Active NPI Psychologist · Andersen Afb, GU
NPI 1992573802 · NPPES record last updated Dec 20, 2023
Key facts
- NPI
- 1992573802
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychologist 103T00000X
- Practice address
- BLDG 14010
Carolinas Ave
Andersen Afb, GU 96929 - Phone
- (717) 880-1667
- NPI assigned
- Dec 20, 2023
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | Yes |
Addresses
Primary practice location
BLDG 14010
Carolinas Ave
Andersen Afb, GU 96929
Mailing address
PO Box 290262
Yigo, GU 96929-3034
Phone (717) 880-1667
Other providers in Andersen Afb, GU
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 20, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.